Biopsychosocial predictors of chronic pain after Caesarean delivery: a prospective cohort evaluation of the SPACE (Sleep, Pain, Affect, Cognition, Energy)-Postpartum framework
Authors' conclusion
We report that chronic pain after caesarean delivery is common.
Study context
- Population
- Participants undergoing caesarean delivery70% at 3-month follow-up
- Participants
- 143 participants
- Outcome
- Chronic pain (pain persisting at 3 months)
- Follow-up
- 3 months postpartum
Methodological detailsobservational, prediction model (ridge-regularised logistic regression), latent class and mediation analyses, Enrolled February–September 2024
- Observational
- Prediction model (ridge-regularised logistic regression)
- Latent class and mediation analyses
- Enrolled February–September 2024
Main finding
As reported in the abstract
Chronic pain and SPACE-Postpartum model predictors · 3 months
- Chronic pain incidence
- 40% (40/100)
- Inpatient perceived control interference, OR
- 1.13 (95% CI 1.00-1.28; P=0.055)
- 2-week average pain intensity, OR
- 1.43 (95% CI 1.09-1.92; P=0.013)
- Activity interference, OR
- 1.24 (95% CI 1.03-1.51; P=0.028)
- Sleep disturbance, OR
- 1.08 (95% CI 1.01-1.15; P=0.029)
- Model discrimination, apparent AUC
- 0.76 (95% CI 0.67-0.85)
- Optimism-corrected AUC
- 0.71
Observational data: associations, not effects.
Further findings
Pain interference at 3 months, high-burden early latent profile (Sleep, Pain, Cognition)
- β
- 0.88 (95% CI 0.12-1.64; P=0.024)
Mediation analysis
- Acute pain had direct effects; sleep disturbance an independent risk marker for chronic pain
Original publication
Biopsychosocial predictors of chronic pain after Caesarean delivery: a prospective cohort evaluation of the SPACE (Sleep, Pain, Affect, Cognition, Energy)-Postpartum framework. BJA Open. Published 29 April 2026. doi:10.
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