Table 3.
Pain, obstetric and neonatal characteristics
| Variables | Low acute postpartum pain (NRS 0–2) N = 759 |
High acute postpartum pain (NRS ≥ 3) N = 121 |
Unadjusted OR (95% CI) |
P-value |
|---|---|---|---|---|
| Gravida, mean (SD) | 1.8 (1.2) | 1.9 (1.3) | 1.04 (0.89–1.21) | 0.6583 |
| Gestational age (weeks), mean (SD) | 38.1 (1.7) | 38.1 (1.4) | 1.00 (0.83–1.21) | 0.9883 |
| Parity, n (%) | ||||
| Nulliparous | 394 (70.1) | 77 (81.9) | Reference | -- |
| Multiparous | 168 (29.9) | 17 (18.1) | 0.52 (0.30–0.90) | 0.0202 |
| Menstrual cycles, n (%) | ||||
| Regular | 561 (79.5) | 96 (87.3) | Reference | -- |
| Irregular | 145 (20.5) | 14 (12.7) | 0.56 (0.31–1.02) | 0.0572 |
| Nausea during menstruation before current pregnancy, n (%) | 0.0082a | |||
| Never | 345 (49.0) | 54 (47.4) | Reference | -- |
| Rarely | 219 (31.1) | 44 (38.6) | 1.28 (0.83–1.98) | 0.2579 |
| Sometimes | 124 (17.6) | 9 (7.9) | 0.46 (0.22–0.97) | 0.0404 |
| Always | 16 (2.3) | 7 (6.1) | 2.80 (1.10–7.11) | 0.0309 |
| Contraceptive use, n (%) | 0.3664a | |||
| None | 603 (91.1) | 98 (92.5) | Reference | -- |
| Oral contraceptive | 15 (2.3) | 4 (3.8) | 1.64 (0.53–5.05) | 0.3876 |
| Others | 44 (6.6) | 4 (3.8) | 0.56 (0.20–1.59) | 0.2762 |
| Current pregnancy, n (%) | 0.4593a | |||
| Unplanned | 195 (27.2) | 27 (23.7) | 0.80 (0.50–1.27) | 0.3433 |
| Planned: Natural | 455 (63.5) | 79 (69.3) | Reference | -- |
| Planned: Assisted | 67 (9.3) | 8 (7.0) | 0.69 (0.32–1.49) | 0.3416 |
| Labor analgesia, n (%) | ||||
| None | 26 (3.4) | 3 (2.5) | 0.72 (0.21–2.41) | 0.5903 |
| Epidural analgesia | 606 (79.8) | 97 (80.2) | 1.02 (0.63–1.65) | 0.9346 |
| Pethidine | 124 (16.3) | 29 (24.0) | 1.61 (1.02–2.56) | 0.0412 |
| Entonox | 477 (62.8) | 79 (65.3) | 1.11 (0.74–1.66) | 0.6049 |
| Remifentanil | 8 (1.1) | 1 (0.8) | 0.78 (0.10–6.31) | 0.8178 |
| Mode of delivery, n (%) | 0.0627 a | |||
| Normal vaginal delivery | 492 (64.8) | 72 (59.5) | Reference | -- |
| Emergency cesarean delivery | 181 (23.8) | 26 (21.5) | 0.99 (0.61–1.59) | 0.9395 |
| Instrumental delivery | 86 (11.3) | 23 (19.0) | 1.83 (1.08–3.08) | 0.0237 |
| Menstrual cycles, n (%) | ||||
| Regular | 561 (79.5) | 96 (87.3) | Reference | -- |
| Irregular | 145 (20.5) | 14 (12.7) | 0.56 (0.31–1.02) | 0.0572 |
| Postpartum obstetric complications, n (%)b | ||||
| None | 623 (83.6) | 91 (78.4) | Reference | -- |
| Yes | 122 (16.4) | 25 (21.6) | 1.40 (0.87–2.28) | 0.1694 |
| Neonatal complications, n (%)c | ||||
| None | 708 (95.3) | 110 (94.8) | Reference | -- |
| Yes | 35 (4.7) | 6 (5.2) | 1.10 (0.45–2.68) | 0.8283 |
| Duration of second stage of labor (mins), mean (SD) | 62.9 (59.7) | 78.3 (62.1) | 1.004 (1.001–1.01) | 0.0225 |
| Blood loss during delivery (mL), mean (SD) | 273.1 (135.6) | 310.1 (211) | 1.01 (1.00–1.02)d | 0.0161 |
| Placental weight (g), mean (SD) | 608.5 (119.1) | 643.3 (115.4) | 1.002 (1.001–1.004) | 0.0030 |
| Infant weight (g), mean (SD) | 3178.2 (361.4) | 3279 (382.1) | 1.001 (1.00–1.001) | 0.0047 |
| Infant length (cm), mean (SD) | 49.2 (1.9) | 49.6 (1.8) | 1.13 (1.02–1.25) | 0.0235 |
| APGAR 1’ (0–10), mean (SD) | 8.9 (0.6) | 9.0 (0.2) | 1.47 (0.77–2.80) | 0.2383 |
| APGAR 5’ (0–10), mean (SD) | 9.0 (0.4) | 9.0 (0.1) | 1.45 (0.52–4.04) | 0.4757 |
| Shoulder dystocia, n (%) | ||||
| No | 755 (99.5) | 117 (96.7) | Reference | -- |
| Yes | 4 (0.5) | 4 (3.3) | 6.45 (1.59–26.16) | 0.0090 |
The missing data are as follows: parity (n = 224), menstrual cycles (n = 64), nausea (n = 62), contraceptive use (n = 112), current pregnancy (n = 49), labor analgesia (n = 40), postpartum obstetric complications (n = 19), neonatal complications (n = 21), duration of second stage (n = 205), blood loss during delivery (n = 2), placental weight (n = 1), and infant length (n = 5)
CI confidence interval; NRS numerical rating scale; OR odds ratio; SD standard deviation
a Type III p-value
b The subcategories of postpartum obstetric complications were: prolonged labor (n = 63), emergency/crash caesarean delivery (n = 79), failed anesthesia for caesarean section (n = 1), postpartum hemorrhage (n = 5) and others (n = 24)
c The subcategories of neonatal complications were: neonatal infection (n = 2), neonatal reflux (n = 6), hospitalization (n = 11), surgical conditions (n = 2), and others (n = 26)
d Calculated for every 10ml blood loss