Persistent Postpartum Pain After Elective Cesarean Section Is Not Only Persistent Postsurgical Pain-A Retrospective...

Background: Persistent postpartum pain (PPP) is a common condition after cesarean section (CS) that affects multiple domains of quality of life. PPP was defined as pain of any cause (not only related to surgery) appearing after CS and persisting for at least the three following months. The objective of this study was to calculate the incidence of PPP in women after elective CS and to analyze the associated risk factors. Methods: It was a retrospective cross-sectional study. An electronic patient-reported outcome tool (ePRO) was used to assess patients' perception of their own health and to assess the presence and severity of pain. Results: Pain during pregnancy was reported by 66.14% of the study group. The most frequently reported localizations of pain were the lumbar spine, pubic symphysis, lower limbs, and sacrococcygeal region. The mean postoperative pain (day 0) defined by a Numeric Rating Scale was 5.44 (2.78 SD), and on the day of discharge (usually the third day after CS), it was 3.6 (2.29 SD). PPP occurred in 32.37% of women, was usually mild in nature, and had a little to moderate impact on function. Previous surgery raises the odds of PPP by 48.7% (OR = 1.487), pain during pregnancy raises the odds of PPP by 48.1% (OR = 1.481), and each additional point of the NRS on day 0 raises the odds of PPP by 16.6% (OR = 1.166). Conclusions: A higher risk of PPP could be found in women with pre-existing pain conditions, previous surgery, and severe postoperative pain. Persistent postpartum pain is not limited only to the area of surgery. Persistent back pain was reported by every second woman with PPP.