Chronic Perinatal Pain as a Risk Factor for Postpartum Depression Symptoms in Canadian Women

Pain and associated factors in depressed and non depressed puerperal women

“…In our study, the positive association between pain and PPD is added to data described in the literature 3,[12][13][14][15][16] . However, one has to stress that pain-related findings are frequently interpreted in terms of duration 3 , presence or absence [12][13][14][15] , without quantifying intensity or considering whether this factor influences depressive symptoms.…”

“…However, one has to stress that pain-related findings are frequently interpreted in terms of duration 3 , presence or absence [12][13][14][15] , without quantifying intensity or considering whether this factor influences depressive symptoms. Our results have shown that, in addition to the relation between these variables, pain intensity referred in the postpartum period may be a predictive signal of depression.…”

“…So, in our study, the thoracic region was the painful area mostly appointed by puerperal women, with EPDS scores equal to or above 13 10 . On the other hand, PPD screening and pain evaluation studies mention as most frequent painful sites "the back" 3,13,18 , generalized term used as synonym for posterior trunk, lumbo-pelvic 12,19 and/or pelvic regions 15 . In addition, authors 12 have observed that depressive symptoms were more frequent in puerperal women with low back pain when applying cutoff points of ≥10 and ≥13 to EPDS, while for puerperal women with pain on pelvic girdle, this comparison was significant only when applying cutoff point of ≥10.…”

“…When investigating the relation between physical and emotional health problems in period of 6 to 9 months postpartum, an Australian study 13 has categorized puerperal women according to respective EPDS scores, in low score group (EPDS<9), group with neighboring values for depression (9<EPDS<12) and group of probable depression (EPDS≥13). To the detriment of methodological heterogeneity, it is fact that most studies suggest a real association between pain and mood disorders in the puerperal period 3,[12][13][14][15][16]18,19 , showing that complications of the pregnancy-puerperal cycle are multifactorial and definitely emphasize mutual complex interactions among environment, psyche and soma 1 . Notwithstanding presented results, it is important to discuss methodological limitations of our study.…”

“…Within this perspective, puerperal pain and postpartum depression (PPD) may be associated phenomena. Factors predisposing to psychiatric complications and present during gestation, delivery and/or after delivery, may amplify pain perception 3 . Such factors include conflicts with regard to ORIGINAL ARTICLE DOI 10.5935/1806-0013.20140022 female identity, traumatic experiences during early stages of psycho-sexual development, adverse socioeconomic situation, education level, fear and anxiety, especially in the absence of companion's support 1 .…”