Influence of body posture on the association between postpartum depression and pain

OBJECTIVE: To determine the association between postpartum depression (PPD), intensification of back pain and exacerbation of changes in postural alignment intrinsic to puerperium. METHODS: Eighty women at 2 to 30 weeks postpartum were included in the study according to the following criteria: literate mothers, gestation of 34 to 42 weeks, and healthy live-born infants. All mothers agreed to participate in the study. Depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). Pain was assessed using a visual analogue scale (VAS) and the Nordic Musculoskeletal Questionnaire (NMQ), and posture, using real time naturalistic observation. RESULTS: There was a statistically significant association between PPD and pain intensity (p = 0.002). The upper back was the most frequent pain site among depressed women, both before (p = 0.04) and after delivery (p = 0.01). There were no associations between PPD and type of posture (p = 0.328). However, pain intensity was greater among depressed women in the swayback group (p < 0.001). CONCLUSION: The intensification of puerperal pain is closely associated with PPD. Our results suggest that back pain may be both a risk factor and a comorbidity of PPD among puerperal women and that pain and type of posture are interdependent.