Glowacka Maria, Rosen Natalie, Chorney Jill, Snelgrove Clarke Erna, George Ronald B
Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada.
J Sex Med. 2014 Dec;11(12):3021-34. doi: 10.1111/jsm.12675. Epub 2014 Aug 15.
There is limited knowledge regarding the symptom profile of genito-pelvic pain in pregnancy and postpartum, and potential psychosocial predictors of this pain. Prior studies have reported a positive association between prepregnancy pain and postpartum genito-pelvic pain. Greater fear avoidance has been associated with increased genital pain intensity in women, unrelated to childbirth. This relationship has not been examined prospectively in a postpartum population.
The study aims were to examine the symptom profile of genito-pelvic pain during pregnancy and at 3 months postpartum, and the impact of prepregnancy nongenito-pelvic pain and fear avoidance in pregnancy on genito-pelvic pain at 3 months postpartum.
First-time expectant mothers (N = 150) completed measures of fear avoidance (pain-related anxiety, catastrophizing, hypervigilance to pain), prepregnancy nongenito-pelvic pain, childbirth-related risk factors (e.g., episiotomy), and breastfeeding.
Those reporting genito-pelvic pain in pregnancy and/or at 3 months postpartum answered questions about the onset (prepregnancy, during pregnancy, postpartum) and location (genital, pelvic, or both) of the pain and rated the intensity and unpleasantness of the pain on numerical rating scales.
Of 150 women, 49% reported genito-pelvic pain in pregnancy. The pain resolved for 59% of women, persisted for 41%, and 7% of women reported a new onset of genito-pelvic pain after childbirth. Prepregnancy nongenito-pelvic pain was associated with an increased likelihood of postpartum onset of genito-pelvic pain. Greater pain-related anxiety was associated with greater average genito-pelvic pain intensity at 3 months postpartum.
Results suggest that about half of women may develop genito-pelvic pain during pregnancy, which will persist for about a third, and a subset will develop this pain after childbirth. Prior recurrent nongenito-pelvic pain may enhance the risk of developing genito-pelvic pain postpartum, while greater pain-related anxiety in pregnancy may increase the risk for greater intensity of postpartum genito-pelvic pain.
关于妊娠和产后生殖器 - 盆腔疼痛的症状特征以及这种疼痛潜在的社会心理预测因素，我们所知有限。先前的研究报告称，孕前疼痛与产后生殖器 - 盆腔疼痛之间存在正相关。更大的恐惧回避与女性生殖器疼痛强度增加有关，这与分娩无关。这种关系尚未在产后人群中进行前瞻性研究。
本研究旨在调查妊娠期间和产后3个月时生殖器 - 盆腔疼痛的症状特征，以及孕前非生殖器 - 盆腔疼痛和妊娠期间的恐惧回避对产后3个月生殖器 - 盆腔疼痛的影响。
首次怀孕的准妈妈（N = 150）完成了恐惧回避（与疼痛相关的焦虑、灾难化、对疼痛的过度警觉）、孕前非生殖器 - 盆腔疼痛、分娩相关风险因素（如会阴切开术）及母乳喂养的测量。
那些报告在妊娠期间和/或产后3个月有生殖器 - 盆腔疼痛的人回答了关于疼痛发作（孕前、孕期、产后）和位置（生殖器、盆腔或两者皆有）的问题，并在数字评分量表上对疼痛强度和不愉快程度进行评分。
150名女性中，49%报告在妊娠期间有生殖器 - 盆腔疼痛。59%的女性疼痛缓解，41%持续存在，7%的女性在产后报告出现新的生殖器 - 盆腔疼痛。孕前非生殖器 - 盆腔疼痛与产后生殖器 - 盆腔疼痛发作的可能性增加有关。更大的与疼痛相关的焦虑与产后3个月时生殖器 - 盆腔疼痛的平均强度更大有关。
结果表明，约一半的女性在妊娠期间可能会出现生殖器 - 盆腔疼痛，其中约三分之一会持续存在，一小部分会在产后出现这种疼痛。先前反复出现的非生殖器 - 盆腔疼痛可能会增加产后发生生殖器 - 盆腔疼痛的风险，而妊娠期间更大的与疼痛相关的焦虑可能会增加产后生殖器 - 盆腔疼痛强度更大的风险。
