The incidence of chronic pain following Cesarean section and associated risk factors: a cohort of women followed up for three months
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2020
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Background
Chronic post-surgical pain (CPSP) is one of the post-surgical complications of a Cesarean
section. Despite the high rates of Cesarean section worldwide, the incidence of CPSP and
the risk factors for this condition remain relatively unknown. The objective of this study was
to calculate the incidence of CPSP in women submitted to Cesarean section and to analyze
the associated risk factors.
Materials and methods
A prospective cohort of 621 women undergoing Cesarean section was recruited preopera tively. Potential presurgical (sociodemographic, clinical and lifestyle-related characteristics)
and post-surgical risk factors (the presence and intensity of pain) risk factors were analyzed.
Pain was measured at 24 hours and 7, 30, 60 and 90 days after surgery. Following dis charge from hospital, data were collected by telephone. The outcome measure was self reported pain three months after a Cesarean section. The risk factors for chronic pain were
analyzed using the log-binomial regression model (a generalized linear model).
Results
A total of 462 women were successfully contacted 90 days following surgery. The incidence
of CPSP was 25.5% (95%CI: 21.8–29.7). Risk factors included presurgical anxiety
(adjusted relative risk [RR] 1.03; 95%CI: 1.01–1.05), smoking (adjusted RR 2.22; 95%CI:
1.27–3.88) and severe pain in the early postoperative period (adjusted RR 2.79; 95%CI:
1.29–6.00).
Conclusion
One in four women submitted to Cesarean section may develop CPSP; however, the risk
factors identified here are modifiable and preventable. Preventive strategies directed
towards controlling anxiety, reducing smoking during pregnancy and managing pain soon
after hospital discharge are recommended
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BORGES, Natália Carvalho et al. The incidence of chronic pain following Cesarean section and associated risk factors: a cohort of women followed up for three months. Plos One, San Francisco, v. 15, n. 9, e0238634-10, 2020. DOI: 10.1371/journal.pone.0238634. Disponível em: https://pmc.ncbi.nlm.nih.gov/articles/PMC7473578/. Acesso em: 2 ab. 2025.