Chronic perinatal pain as a risk factor for postpartum depression symptoms in Canadian women.

OBJECTIVE To examine whether problematic perinatal pain is associated with postpartum depression (PPD) symptoms in a large nationally representative sample of Canadian mothers. METHODS We conducted a secondary data analysis using the 2006 Canadian Maternity Experiences Survey data (n=5,614). The main exposures of interest were the presence of problematic perinatal pain at three months postpartum, the duration of problematic perinatal pain, and the number of types of perinatal pain (vagina, caesarean incision site, breasts, back, severe headaches) at the time of interview (mean=7.3 months, range 5-14 months). For each exposure, full multivariate logistic regression models as well as six submodels were fitted. RESULTS Odds of screening positive for PPD symptoms for respondents reporting problematic perinatal pain in the first three months postpartum were 1.7 (95% CI 1.2-2.5). Compared to respondents without problematic perinatal pain, the odds of PPD symptoms for women reporting problematic perinatal pain at the time of interview was 2.4 (95% CI 1.6-3.6). A dose-response association between the number of types of perinatal pain at the time of interview and PPD symptoms was also observed. CONCLUSION Mothers reporting persistent perinatal pain are at increased risk of developing PPD, and pain control services for these women may be needed.