Table 4.
Demographic, clinical, and psychological factors associated with chronic pain at 3, 6 and 12 months after Cesarean section
| 3 months | 6 months | 12 months | |||||||
|---|---|---|---|---|---|---|---|---|---|
| Chronic pain (n = 92) | No chronic pain (n = 410) | P value | Chronic pain (n = 55) | No chronic pain (n = 432) | P value | Chronic pain (n = 32) | No chronic pain (n = 440) | P value | |
| Age (year, mean ± SD) | 30 ± 4 | 29 ± 4 | 0.354 | 29 ± 4 | 29 ± 4 | 0.780 | 30 ± 4 | 29 ± 4 | 0.346 |
| Body mass index (mean ± SD) | 28.4 ± 1.7 | 28.3 ± 1.6 | 0.400 | 28.3 ± 1.8 | 28.3 ± 1.6 | 0.803 | 28.5 ± 1.7 | 28.3 ± 1.6 | 0.432 |
| Gestational age (week, mean ± SD) | 38.9 ± 1.3 | 39.0 ± 1.0 | 0.469 | 38.9 ± 1.4 | 39.0 ± 1.0 | 0.458 | 38.9 ± 1.5 | 39.0 ± 1.0 | 0.406 |
| Pain prior to pregnancy, n (%) | 0.986 | 0.334 | 0.230 | ||||||
| Yes | 4 (4.3 %) | 18 (4.4 %) | 1 (1.8 %) | 20 (4.6 %) | 0 | 19 (4.3 %) | |||
| No | 88 (95.7 %) | 392 (95.6 %) | 54 (98.2 %) | 412 (95.4 %) | 32 (100 %) | 421 (95.7 %) | |||
| Pain during pregnancy, n (%) | 0.241 | 0.062 | 0.205 | ||||||
| Yes | 9 (9.8 %) | 26 (6.3 %) | 7 (12.7 %) | 26 (6.0 %) | 4 (12.5 %) | 29 (6.6 %) | |||
| No | 83 (90.2 %) | 384 (93.7 %) | 48 (87.3 %) | 406 (94.0 %) | 28 (87.5 %) | 411 (93.4 %) | |||
| Pain with menstruation, n (%) | 0.634 | 0.966 | 0.117 | ||||||
| Yes | 23 (25.0 %) | 93 (22.7 %) | 13 (23.6 %) | 101 (23.4 %) | 11 (34.4 %) | 98 (22.3 %) | |||
| No | 69 (75.0 %) | 317 (77.3 %) | 42 (76.4 %) | 331 (76.6 %) | 21 (65.6 %) | 342 (77.7 %) | |||
| Previous vaginal delivery, n (%) | 0.916 | 0.769 | 0.980 | ||||||
| Yes | 6 (6.5 %) | 28 (6.8 %) | 3 (5.5 %) | 28 (6.5 %) | 2 (6.3 %) | 28 (6.4 %) | |||
| No | 86 (93.5 %) | 382 (93.2 %) | 52 (94.5 %) | 404 (93.5 %) | 30 (93.8 %) | 412 (93.6 %) | |||
| Previous cesarean delivery, n (%) | 0.012 | 0.037 | 0.009 | ||||||
| Yes | 14 (15.2 %) | 29 (7.1 %) | 9 (16.4 %) | 34 (7.9 %) | 7 (21.9 %) | 36 (8.2 %) | |||
| No | 78 (84.8 %) | 381 (92.9 %) | 46 (83.6 %) | 398 (92.1 %) | 25 (78.1 %) | 404 (91.8 %) | |||
| Previous pelvic surgery, n (%) | 0.572 | 0.648 | 0.229 | ||||||
| Yes | 12 (13.0 %) | 63 (15.4 %) | 7 (12.7 %) | 65 (15.0 %) | 7 (21.9 %) | 62 (14.1 %) | |||
| No | 80 (87.0 %) | 347 (84.6 %) | 48 (87.3 %) | 367 (85.0 %) | 25 (78.1 %) | 378 (85.9 %) | |||
| History of diabetes, n (%) | 0.656 | 0.602 | 0.337 | ||||||
| Yes | 21 (22.8 %) | 85 (20.7 %) | 13 (23.6 %) | 89 (20.6 %) | 9 (28.1 %) | 92 (20.9 %) | |||
| No | 71 (77.2 %) | 325 (79.3 %) | 42 (76.4 %) | 343 (79.4 %) | 23 (71.9 %) | 348 (79.1 %) | |||
| History of hypertension, n (%) | 0.857 | 0.602 | 0.230 | ||||||
| Yes | 7 (7.6 %) | 29 (7.1 %) | 5 (9.1 %) | 31 (7.2 %) | 4 (12.5 %) | 30 (6.8 %) | |||
| No | 85 (92.4 %) | 381 (92.9 %) | 50 (90.9 %) | 401 (92.8 %) | 28 (87.5 %) | 410 (93.2 %) | |||
| Number of fetuses, n (%) | 0.370 | 0.914 | 0.788 | ||||||
| 1 | 90 (97.8 %) | 393 (95.9 %) | 53 (96.4 %) | 415 (96.1 %) | 31 (96.9 %) | 422 (95.9 %) | |||
| 2 | 2 (2.2 %) | 17 (4.1 %) | 2 (3.6 %) | 17 (3.9 %) | 1 (3.1 %) | 18 (4.1 %) | |||
| EPDS score (mean ± SD) | <0.001 | <0.001 | 0.007 | ||||||
| < 12 | 74 (80.4 %) | 393 (95.9 %) | 42 (76.4 %) | 411 (95.1 %) | 26 (81.3 %) | 413 (93.9 %) | |||
| ≥ 12 | 18 (19.6 %) | 17 (4.1 %) | 13 (23.6 %) | 21 (4.9 %) | 6 (18.8 %) | 27 (6.1 %) | |||
| sSTAI score (mean ± SD) | 0.321 | 0.500 | 0.782 | ||||||
| ≤ 40 | 60 (65.2 %) | 289 (70.5 %) | 36 (65.5 %) | 302 (69.9 %) | 23 (71.9 %) | 306 (69.5 %) | |||
| > 40 | 32 (34.8 %) | 121 (29.5 %) | 19 (34.5 %) | 130 (30.1 %) | 9 (28.1 %) | 134 (30.5 %) | |||
| tSTAI score (mean ± SD) | 0.306 | 0.245 | 0.944 | ||||||
| ≤ 40 | 51 (55.4 %) | 251 (61.2 %) | 29 (60.0 %) | 263 (60.9 %) | 19 (59.4 %) | 264 (60.0 %) | |||
| > 40 | 41 (44.6 %) | 159 (38.8 %) | 26 (47.3 %) | 169 (39.1 %) | 13 (40.6 %) | 176 (40.0 %) | |||
| Type of anesthesia, n (%) | 0.089 | 0.007 | 0.031 | ||||||
| General anesthesia | 12 (13.0 %) | 31 (7.6 %) | 10 (18.2 %) | 32 (7.4 %) | 6 (18.8 %) | 34 (7.7 %) | |||
| Epidural anesthesia | 80 (8.7 %) | 379 (92.4 %) | 45 (81.8 %) | 400 (92.6 %) | 26 (81.3 %) | 406 (92.3 %) | |||
| Type of surgery, n (%) | 0.505 | 0.145 | 0.274 | ||||||
| Elective | 49 (53.3 %) | 234 (57.1 %) | 36 (65.5 %) | 238 (55.1 %) | 21 (65.6 %) | 245 (55.7 %) | |||
| Emergent | 43 (46.7 %) | 176 (42.9 %) | 19 (34.5 %) | 194 (44.9 %) | 11 (34.4 %) | 195 (44.3 %) | |||
| Duration of surgery (min, mean ± SD) | 46.8 ± 8.2 | 42.3 ± 6.8 | <0.001 | 47.0 ± 7.0 | 42.6 ± 7.2 | <0.001 | 48.4 ± 6.8 | 42.7 ± 7.1 | <0.001 |
| Type of incision, n (%) | 0.965 | 0.565 | 0.986 | ||||||
| Vertical | 3 (3.3 %) | 13 (3.2 %) | 1 (1.8 %) | 14 (3.2 %) | 1 (3.1 %) | 14 (3.2 %) | |||
| Pfannenstiel | 89 (96.7 %) | 397 (96.8 %) | 54 (98.2 %) | 418 (96.8 %) | 31 (96.9 %) | 426 (96.8 %) | |||
| Blood loss (mL, mean ± SD) | 212 ± 126 | 193 ± 94 | 0.103 | 221 ± 130 | 194 ± 97 | 0.058 | 255 ± 152 | 193 ± 96 | 0.001 |
| Average pain intensity at rest within 24 h postoperatively (mean ± SD) | 2.0 ± 0.6 | 1.7 ± 0.5 | <0.001 | 2.1 ± 0.6 | 1.7 ± 0.5 | <0.001 | 2.1 ± 0.6 | 1.7 ± 0.5 | <0.001 |
| Average pain intensity on movement within 24 h postoperatively (mean ± SD) | 3.7 ± 0.9 | 3.2 ± 0.7 | <0.001 | 3.9 ± 0.8 | 3.2 ± 0.8 | <0.001 | 3.9 ± 0.8 | 3.2 ± 0.7 | <0.001 |