Predictive factors for chronic pain related to childbirth: A prospective cohort study

Chronic postpartum pain is an understudied maternal health issue, and large prospective studies examining predictive factors are scarce. This study aimed to identify predictive factors for chronic pain 8 months after childbirth.

This exploratory analysis was based on data from a prospective multicenter cohort study. Data were collected through two questionnaires and the Obstetrix record system. Swedish-speaking women who gave birth to a live infant completed a baseline questionnaire 24-36 h postpartum (n = 1507), with follow-up at 8 months. Chronic pain was defined as pain with onset in relation to labor and still present at 8 months postpartum. A total of 1171 women (77.7%) completed the eight-month follow-up questionnaire and were included in the analyses. Crude and multivariable logistic regression analyses were performed to identify factors associated with chronic postpartum pain.

Eight months after giving birth, 89/1171 (7.6%) of the women reported chronic pain related to labour. In the multivariable logistic regression analysis, menstrual pain before pregnancy (aOR 2.07, 95% CI 1.24-3.47), dyspareunia before pregnancy (aOR 2.08, 95% CI 1.12-3.89), chronic pain before pregnancy (aOR 2.11, 95% CI 1.19-3.74), pain lasting more than 3 months during pregnancy (aOR 2.14, 95% CI 1.24-3.70), and moderate or severe acute postpartum pain (NRS 4-10; aOR 2.16, 95% CI 1.16-4.02) were independently associated with chronic postpartum pain.

Pain-related conditions before and during pregnancy, together with moderate or severe acute postpartum pain, were associated with chronic postpartum pain 8 months after childbirth. Several predictive factors can be identified before childbirth, providing an opportunity to identify women at increased risk, while acute postpartum pain underscores the importance of timely pain assessment and management.