Trajectories of pain intensity, pain catastrophizing, and pain interference in the perinatal and postpartum period

Jenna Jessa; Lianne Tomfohr-Madsen; Ashley Dhillon; Andrew Walker; Melanie Noel; Ivan Sedov; Jillian Vinall Miller

doi:10.1097/PR9.0000000000001137

Trajectories of pain intensity, pain catastrophizing, and pain interference in the perinatal and postpartum period

Pain Rep. 2024 Jan 7;9(2):e1137. doi: 10.1097/PR9.0000000000001137. eCollection 2024 Apr.

Authors

Jenna Jessa^{1

2

3

4

5

6}, Lianne Tomfohr-Madsen⁷, Ashley Dhillon⁸, Andrew Walker^{1

9}, Melanie Noel^{2

3

4

5

10}, Ivan Sedov⁹, Jillian Vinall Miller^{1

2

3

4

5

6}

Affiliations

¹ Department of Anesthesiology, Perioperative & Pain Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
² Vi Riddell Children's Pain & Rehabilitation Centre, Alberta Children's Hospital, Calgary, AB, Canada.
³ The Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Calgary, AB, Canada.
⁴ Child Brain & Mental Health Program, Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
⁵ Owerko Centre, Alberta Children's Hospital Research Institute, Calgary, AB, Canada.
⁶ O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
⁷ Faculty of Education: Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC, Canada.
⁸ Department of Psychology, University of Toronto, Toronto, ON, Canada.
⁹ Alberta Health Services, Calgary, AB, Canada.
¹⁰ Department of Psychology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Abstract

Introduction: Chronic pain (pain >3 months) is a growing epidemic. Normal pregnancy may give rise to recurrent and sometimes constant pain for women. Women with worse pain symptoms are more likely to report symptoms of anxiety, depression, and/or insomnia during the perinatal period, which may impact labor and delivery outcomes. We examined the relationship between demographic and psychological predictors of pain throughout pregnancy and into the postpartum.

Objectives: To examine trajectories of pain intensity, pain catastrophizing, and pain interference during pregnancy and the early postpartum, and associated sociodemographic predictors of trajectory membership.

Methods: One hundred forty-two pregnant women were assessed at 4 time points for measures of pain intensity, pain catastrophizing, pain interference, and symptoms of insomnia, depression, and generalized anxiety. Women completed the first survey before 20 weeks' gestation and were reassessed every 10 weeks. Surveys were completed on average at 15 weeks', 25 weeks', and 35 weeks' gestation, and at 6-week postpartum. Using latent class mixed models, trajectory analysis was used to determine trajectories of pain intensity, pain catastrophizing, and pain interference.

Results: A 1-class pain intensity model, 2-class pain catastrophizing model, and 3-class pain interference model were identified. Adaptive lasso and imputation demonstrated model robustness. Individual associations with trajectories included baseline symptoms of anxiety, depression, and insomnia, and pain symptomology.

Conclusion: These findings may help to identify women who are at high risk for experiencing pain symptoms during pregnancy and could aid in developing targeted management strategies to prevent mothers from developing chronic pain during their pregnancy and into the postpartum period.

Keywords: Gestation; Maternal; Pain assessment; Postnatal; Pregnancy; Prenatal.