Changes in birth-related pain perception impact of neurobiological and psycho-social factors.
Arch Gynecol Obstet
; 297(3): 591-599, 2018 03.
Article
em En
| MEDLINE
| ID: mdl-29196870
ABSTRACT
PURPOSE:
To analyse post-partum short- and long-term pain sensitivity and the influence of endogenous pain inhibition as well as distinct psycho-social factors on birth-related pain.METHODS:
Pain sensitivity was assessed in 91 primiparous women at three times 2-6 weeks before, one to 3 days as well as ten to 14 weeks after childbirth. Application of a pressure algometer in combination with a cold pressor test was utilised for measurement of pain sensitivity and assessment of conditioned pain modulation (CPM). Selected psycho-social factors (anxiety, social support, history of abuse, chronic pain and fear of childbirth) were evaluated with standardised questionnaires and their effect on pain processing then analysed.RESULTS:
Pressure pain threshold, cold pain threshold and cold pain tolerance increased significantly directly after birth (all p < 0.001). While cold pain parameters partly recovered on follow-up, pressure pain threshold remained increased above baseline (p < 0.001). These pain-modulating effects were not found for women with history of abuse. While CPM was not affected by birth, its extent correlated significantly (r = 0.367) with the drop in pain sensitivity following birth. Moreover, high trait anxiety predicted an attenuated reduction in pain sensitivity (r = 0.357), while there was no correlation with fear of childbirth, chronic pain and social support.CONCLUSION:
Pain sensitivity showed a decrease when comparing post-partum with prepartum values. The extent and direction of CPM appear to be a trait variable that predicted post-partum hypalgesia without being changed itself. Post-partum hypalgesia was reduced in women with a history of abuse and high trait anxiety, which suggests that individual differences in CPM affect childbirth experience.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Ansiedade
/
Apoio Social
/
Estresse Psicológico
/
Limiar da Dor
/
Gestantes
/
Dor do Parto
/
Medo
/
Percepção da Dor
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article