Abstract
Objective
To examine whether problematic perinatal pain is associated with postpartum depression (PPD) symptoms in a large nationally representative sample of Canadian mothers.
Methods
We conducted a secondary data analysis using the 2006 Canadian Maternity Experiences Survey data (n=5,614). The main exposures of interest were the presence of problematic perinatal pain at three months postpartum, the duration of problematic perinatal pain, and the number of types of perinatal pain (vagina, caesarean incision site, breasts, back, severe headaches) at the time of interview (mean=7.3 months, range 5–14 months). For each exposure, full multivariate logistic regression models as well as six submodels were fitted.
Results
Odds of screening positive for PPD symptoms for respondents reporting problematic perinatal pain in the first three months postpartum were 1.7 (95% CI 1.2-2.5). Compared to respondents without problematic perinatal pain, the odds of PPD symptoms for women reporting problematic perinatal pain at the time of interview was 2.4 (95% CI 1.6-3.6). A dose-response association between the number of types of perinatal pain at the time of interview and PPD symptoms was also observed.
Conclusion
Mothers reporting persistent perinatal pain are at increased risk of developing PPD, and pain control services for these women may be needed.
Key Words: Postpartum depression, chronic pain, perinatal care, risk factors, maternal health
Résumé
Objectif
Examiner si la douleur périnatale problématique est associée aux symptômes de la dépression postpartum (DPP) dans un échantillon national représentatif de mères canadiennes.
Méthodes
Nous avons effectué une analyse secondaire des données de l’Enquête sur l’expérience de la maternité au Canada de 2006 (n=5 614). Les variables dépendantes étaient la présence de douleurs périnatales problématiques dans les trois premiers mois postpartum, la durée des douleurs périnatales problématiques, ainsi que le nombre de types de douleurs périnatales encore présentes lors de l’entrevue qui a eu lieu en moyenne à 7,3 mois postpartum (étendue: 5 à 14 mois). Un modèle de régression logistique multivariée complet ainsi que six sous-modèles ont été construits pour chacune de ces variables dépendantes.
Résultats
Les chances de répondre positivement au dépistage des symptômes de la DPP pour les répondantes ayant déclaré une douleur périnatale problématique étaient de 1,7 (IC 95% 1,2-2,5). Le rapport de cotes pour les femmes souffrant encore de douleurs périnatales problématiques lors de l’entrevue était de 2,4 (IC 95% 1,6-3,6) comparativement aux répondantes ne souffrant pas de douleurs problématiques. Une relation dose-réponse entre le nombre de types de douleurs périnatales et les symptômes de la DPP a également été observée.
Conclusion
Les mères qui signalent une douleur persistante périnatale ont un risque accru de DPP et pourraient nécessiter des services de contrôle de la douleur.
Mots Clés: dépression post-partum, douleur chronique, santé périnatale, facteur de risque, santé maternelle
Footnotes
Acknowledgements: At the time of the study, Caroline Gaudet was an MSc (Epidemiology) candidate and a recipient of a Frederick Banting and Charles Best Canada Graduate Scholarships — Master’s Award from the Canadian Institutes of Health Research (CIHR). The authors thank the staff at the Carleton, Ottawa, Outaouais Local Research Data Centre (COOL-RDC) for their help in accessing the survey data.
Disclaimers: The present research and analyses are based on data from Statistics Canada and the opinions expressed do not represent the views of Statistics Canada.
Conflict of Interest: None to declare.
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