The Relationship between Physical Activity during Pregnancy, Post-Cesarean-Section Pain, and Analgesia Requirement

The cesarean section increases worldwide and has many side effects, including acute pain. This study investigated the relationship between physical activity during pregnancy, analgesic consumption, and maximal postoperative pain in women with low segment cesarean section.

340 Cesarean section women were interviewed by demographic and global physical activity questionnaires during the pre-operative visits. The participants were categorized into high, moderate, and low physical activity groups (high PA, moderate PA, low PA, respectively) according to the global physical activity questionnaire guidelines. The maximal postoperative pain (MPP), the type, and doses of analgesia used/2 days were recorded. Pearson correlation, Chi-square, and one-way ANOVA were used to analyze the data.

MPP was reduced in the high PA group (5.48 ±1.72) compared to the moderate (6.46±1.30) and low PA groups (6.97±1.92; p<0.0005, p<0.0005, respectively). There was a difference between the moderate and low PA groups (p=0.04). Paracetamol was the common analgesic without significant difference among groups (p=0.37). The numbers of paracetamol doses significantly reduced in the high PA group (3.31±1.65) compared to the low PA group (4.03±2.01, p=0.01). MPP had a significant and low negative correlation with total physical activity (r=-0.25, p=0.0005). There was a negative significant correlation between occupation (r=-.491, p=0.0005), recreational (r=-.262, p=0.0005), and travel activities (r=-.150. p=0.006) with MPP. There was a low positive correlation between sedentary activity and MPP (r=0.23, p=0.0005). 

Maternal physical activity can be a non-pharmacological and cost-effective method of pain management.