Pain catastrophizing and its associated factors among puerperal women with vaginal birth : a cross-sectional study

Key Findings

To investigate the prevalence of pain catastrophizing among women with vaginal birth and explore its associated factors. In this cross-sectional study, a total of 282 participants who met the inclusion and exclusion criteria were selected by convenience sampling from Delivery Room Ward of a hospital in Sichuan Province. Pain Catastrophizing Scale, Pain Numerical Rating Scale, Social Support Rating Scale, Hospital Anxiety and Depression Scale, Pain Self-Efficacy Scale and general information questionnaire were used to assess pain catastrophizing (PC), pain intensity, social support, anxiety, depressive symptoms, pain self-efficacy and sociodemographic information of the participants, respectively. Data were collected in two stages: latent period of the first stage of labor (T1) and the second stage of labor (T2). According to the distribution and type of the data, the mean and standard deviation (SD), median and quartiles, frequency and percentages were used for statistical description. The generalized estimating equation (GEE) was used to analyze the associated factors of pain catastrophizing. Crossed-lagged regression was used to explore the relationship between pain intensity and pain catastrophizing. The median and quartiles of PCS scores at T1 and T2 were 30.00 (21.00, 39.00) and 27.00 (17.00, 40.00) among the participants, respectively. The prevalence of pain catastrophizing at T1 and T2 was 29.08% and 29.43%, respectively. Chi-square test showed that the prevalence of pain catastrophizing at T2 was higher than that at T1 (χ2 = 55.387, p<0.001). GEE showed that greater gestational week, greater pain intensity at T1 and T2, and depressive symptoms were potential risk factors of pain catastrophizing (p<0.05), and a higher level of pain self-efficacy was a protective factor of pain catastrophizing among the participants [OR = 0.967, p<0.001]. Compared accompanied by husband, maternities accompanied by others during childbirth were more likely to be pain catastrophic [OR = 0.282, p = 0.010]. The results of cross-lagged analysis showed maternal pain intensity was positively correlated with pain catastrophizing at both T1 (r = 0.357, P < 0.001) and T2(r = 0.603, p < 0.001). There was no correlation between pain catastriphizing at T1 and pain intensity at T2, or pain intensity at T1 and pain catastriphizing at T2. As shown in Fig. 2. There is a high prevalence of pain catastrophizing in women with natural childbirth. Associated factors of pain catastrophizing among women with natural childbirth are multidimensional, including physiological (pain intensity), psychological (gestational age, anxiety, depressive symptoms, pain self-efficacy) and socio-demographic factors (accompanying family members during delivery), suggesting that early evaluation of mental health condition of pregant women should be implemented and targeted interventions should be taken even if during pregnancy by health care workers. During labour, close attention should be paid to the mother's recognition of pain and appropriate measures taken promptly to prevent the occurrence of pain catastrophizing.

Why This Matters for Body-Mind Practice

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Source

• Pain catastrophizing and its associated factors among puerperal women with vaginal birth : a cross-sectional study. — BMC pregnancy and childbirth