Changes in birth-related pain perception impact of neurobiological and psycho-social factors

Berlit, Sebastian; Lis, Stefanie; Hafner, Katharina; Kleindienst, Nikolaus; Baumgärtner, Ulf; Treede, Rolf‐Detlef; Sütterlin, Marc; Schmahl, Christian

doi:10.1007/s00404-017-4605-4

Cited by 7 publications

(12 citation statements)

References 25 publications

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“…While experimental CPM correlated with delivery-induced PPT changes in the CG, in line with earlier results, 9 we now found that this correlation broke down in the TG. While the deficit in pain inhibition in maltreated women is small, it may be a marker of relevant dysfunction and deserves further investigation.…”

Section: Discussionsupporting

confidence: 92%

“…Cold pressor test was administered on the nondominant hand to avoid segmental interaction. The chosen test sites are outside of common pain areas such as the back, allow for a direct comparison with Berlit et al, 9 and are considered to yield the most reliable CPM results. 78 To reduce confusion and nervousness, participants were introduced to the equipment and associated stimuli (except for ice water) before testing.…”

Section: Quantitative Sensory Assessmentsmentioning

confidence: 99%

“…Conditioned pain modulation was quantified by assessing the effect of a CPT as a conditioning stimulus, which is meant to activate endogenous top-down pain inhibitory pathways, on the PPT as a test stimulus. 9,102 To this end, the PPT was reassessed after the CPT. The change from the PPT before the CPT (PPT1) to after the CPT (PPT2) represents the CPM effect.…”

Section: Conditioned Pain Modulation Assessmentmentioning

confidence: 99%

“…Adverse childhood experience-exposed women exhibited deficits in deep pain inhibition through childbirth, consistent with our previous results. 9 Literature on the ability of childbirth to induce hypalgesia is inconsistent across a range of modalities, protocol, and timepoints. Several studies found decreased pain sensitivity intrapartum, 28,79,116 though some disagree.…”

Section: Peripartum Pain Modulationmentioning

confidence: 99%

“…29 Regarding labor pain, literature is limited to sexual abuse, which is reported to increase pain 24,41 and the need for pain medication. 60 Heightened pain thresholds in parous women 44 and findings of increased pain thresholds shortly before, 17,28 during, 28,79 or after delivery 9,17 indicate that birth itself may modulate pain sensitivity. Endogenous pain inhibition can be initiated by nociceptive input through negative feedback through the brainstem and may thus be induced by pain in pregnancy and delivery.…”

Section: Introductionmentioning

confidence: 99%

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The association between adverse childhood experiences and peripartal pain experience

Zehetmeier

Fröhlich

Schilder

et al. 2023

PAIN

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Adverse childhood experiences (ACEs) are associated with altered ongoing and evoked pain experiences, which have scarcely been studied for the peripartum period. We aimed to investigate how ACEs affect pain experience in pregnancy and labor. For this noninterventional trial with a short-term follow-up, pregnant women were divided into a trauma group (TG) with ACEs (n = 84) and a control group (CG) without ACEs (n = 107) according to the Childhood Trauma Questionnaire. Pain experience in pregnancy and labor was recorded by self-report and the German Pain Perception Scale. Pain sensitivity prepartum and postpartum was assessed by Quantitative Sensory Testing and a paradigm of conditioned pain modulation (CPM), using pressure pain thresholds (PPTs) and a cold pressor test. The TG showed higher affective and sensory scores for back pain and a more than doubled prevalence of preexisting back pain. Pelvic pain differences were nonsignificant. The TG also exhibited increased affective scores (1.71 ± 0.15 vs 1.33 ± 0.11), but not sensory scores for labor pain during spontaneous delivery. There were no group differences in prepartum pain sensitivity. While PPTs increased through delivery in the CG (clinical CPM), and this PPT change was positively correlated with the experimental CPM (r = 0.55), this was not the case in the TG. The association of ACEs with increased peripartal pain affect and heightened risk for preexisting back pain suggest that such women deserve special care. The dissociation of impaired clinical CPM in women with ACEs and normal prepartum experimental CPM implies at least partly different mechanisms of these 2 manifestations of endogenous pain controls.

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Section: Discussionsupporting

confidence: 92%

Section: Quantitative Sensory Assessmentsmentioning

confidence: 99%

Section: Conditioned Pain Modulation Assessmentmentioning

confidence: 99%

Section: Peripartum Pain Modulationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The association between adverse childhood experiences and peripartal pain experience

Zehetmeier

Fröhlich

Schilder

et al. 2023

PAIN

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Effects of Reproductive Experience on Cost-Benefit Decision Making in Females and Males

Faraji,

Viera-Resto,

Setlow

et al. 2023

Preprint

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Almost all individuals undergo reproductive and/or parenting experience at some point in their lives, and pregnancy and childbirth in particular are associated with alterations in the prevalence of several psychiatric disorders. Research in rodents shows that maternal experience affects spatial learning and other aspects of hippocampal function. In contrast, there has been little work in animal models concerning how reproductive experience affects cost-benefit decision making, despite the relevance of this aspect of cognition for psychiatric disorders. To begin to address this issue, reproductively experienced (RE) and reproductively naïve (RN) female and male Long-Evans rats were tested across multiple tasks that assess different forms of cost-benefit decision making. In a risky decision-making task, in which rats chose between a small, safe food reward and a large food reward accompanied by variable probabilities of punishment, RE and RN males did not differ, whereas RE females chose the large risky reward significantly more frequently than RN females (greater risk taking). In an intertemporal choice task, in which rats chose between a small, immediate food reward and a large food reward delivered after a variable delay period, RE males chose the large reward more frequently than RN males, whereas RE females chose the large reward less frequently than RN females. Together, these results show distinct effects of reproductive experience on different forms of cost-benefit decision making in rats of both sexes, and highlight reproductive status as a variable that could influence aspects of cognition relevant for psychiatric disorders.

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How can the pain sensitivity to be affected by maximal progressive exercise test during pregnancy?

Leźnicka,

Gasiorowska,

Pawlak

et al. 2024

PLoS ONE

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The multidimensional etiology of pain may explain the beneficial effects of regular physical activity, as evidenced by increased pain tolerance. Physically active people find it easier to exert themselves, which enables them to increase their physical activity, which in turn leads to a reduction in pain. However, no study investigated the physical activity and exercise tests as modulators of pain sensitivity in pregnant women. Therefore, this study aimed to investigate the changes in pain perception in pregnant women during pregnancy, with a particular interest in the effects of maximal progressive exercise test (CPET) and self-performed physical activity (PA). Thirty-one women with an uncomplicated singleton pregnancy (aged 23–41 years; M = 31.29, SD = 4.18) were invited to participate in pain sensitivity measurements before and after CPET twice during pregnancy (with an 8-week break). We found that pregnant women had a significantly lower pain threshold after a maximal exercise test than before, regardless of whether the test was performed in the second or third trimester of pregnancy. This effect was most pronounced in women with low levels of physical activity. Second, women with high physical activity had higher pain tolerance than women with moderate and low physical activity. In addition, physical activity levels predicted changes in pain tolerance over the course of pregnancy, with negative changes in women with low physical activity and positive changes in women with moderate physical activity. Finally, these associations were not reflected in differences in the subjective pain experience.

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Changes in birth-related pain perception impact of neurobiological and psycho-social factors

Cited by 7 publications

References 25 publications

The association between adverse childhood experiences and peripartal pain experience

The association between adverse childhood experiences and peripartal pain experience

Effects of Reproductive Experience on Cost-Benefit Decision Making in Females and Males

How can the pain sensitivity to be affected by maximal progressive exercise test during pregnancy?

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