Pain and associated factors in depressed and non depressed puerperal women

Abstract

BACKGROUND AND OBJECTIVES:Physical pain during puerperium is in general caused by musculoskeletal changes inherent to gestation; however, its clinical progression may be changed by mood disorders. This study aimed at evaluating the association between pain and postpartum depression. METHODS: Participated in the study 80 women at 2 to 30 weeks postpartum. Depressive symptoms were screened with the Edinburgh Postnatal Depression Scale. Pain intensity was evaluated with the analog visual scale, while the Nordic Musculoskeletal Questionnaire was used for pain location. RESULTS: Univariate analysis has shown that postpartum depression was associated to more severe pain (p<0.001), to constant mood changes (p=0.001), to early sexual initiation (p<0.05) and to a larger number of people living together (p<0.05). Chest was the most common painful site referred by depressed puerperal women (p=0.01). Logistic regression analysis has shown that moderate to severe pain was a strong predictor of postpartum depression (OR=4.6; confidence interval 95%: 1.5-13.9). CONCLUSION: Moderate to severe pain increases the probability of puerperal women developing postpartum depressive symptoms. Keywords: Musculoskeletal pain, Pain measurement, Postpartum depression. Pain and associated factors in depressed and non depressed puerperal women* Dor e fatores associados em puérperas deprimidas e não deprimidas RESULTADOS:A análise univariada mostrou que a depressão pós-parto esteve associada à dor de maior intensidade (p<0,001), a alterações constantes de humor (p=0,001), à iniciação sexual precoce (p<0,05) e ao consumo de álcool (p<0,05). Percepção dolorosa de maior intensidade foi associada a um relacionamento conjugal ruim (p<0,05) e a um maior número pessoas em coabitação (p<0,05). A região torácica foi o local de dor mais apontado pelas puérperas deprimidas (p=0,01). A análise de regressão logística revelou que dor referida de moderada a intensa foi um forte fator preditor de depressão pós-parto (OR=4,6; intervalo de confiança de 95%:1,5-13,9). CONCLUSÃO: Dor de intensidade moderada a intensa aumenta a probabilidade de mulheres desenvolverem sintomas depressivos no pós-parto. Descritores: Depressão pós-parto, Dor musculoesquelética, Mensuração da dor.

Prevalence of anxiety and depression disorder and associated factors during postpartum in puerperal women

“…In these periods, an ideal model of the perfect mother is expected, i.e., a romanticized image of motherhood that is grounded in a rigid standard incapable of admitting any trace of ambivalent feelings that she may feel. 7 Such demands explain why the risk of developing depression is three times higher in the first month of puerperium, when compared to other periods of a woman's life. 8 Regarding to the symptoms of depression associated with the birth of a baby, they usually start between the fourth and eighth week after childbirth, commonly reaching their maximum intensity in the first six months, being the second cause of illness in women in the world, which may lead to suicide, one of the main mortality factors among women of childbearing age.…”

“…Angelo et al 7 describe that depression and anxiety are often mood disorders, usually associated with persistent clinical condition of pain. In this perspective, due to the fear-tension-pain triad that coexist in pregnancy, childbirth and postpartum, where the emotional situation is directly related to muscle and physiological functions, the evolution of depression may then occur in women in the postpartum period.…”