Psychological distress and self-rated health status in reproductive aged women with pain: findings from a national, cross-sectional survey

Background: Pain impacts upon psychological wellbeing. In pregnant and postpartum women psychological distress may negatively affect the mother-infant relationship and lead to adverse infant development. Yet, co-occurrence of pain with psychological distress in women of reproductive age has not been investigated. Therefore, this study aimed to: 1) assess prevalence of psychological distress in reproductive aged women by pain severity; and 2) examine the self-rated health status of reproductive aged women with and without pain.

Method: Data for women aged 18-49 years were obtained from the 2011-12 Australian Bureau of Statistics National Health Survey. Sample data were weighted to give population estimates. Recent pain severity, self-rated health and psychological distress were analysed for pregnant, breastfeeding and non-pregnant/non-breastfeeding women.

Results: Moderate-to-very severe pain was reported by 17.6% of pregnant (sample n = 165, weighted N = 191,856), 25.9% of breastfeeding (sample n = 210, weighted N = 234,601) and 23.9% of non-pregnant/non-breastfeeding women (sample n = 4005, weighted N = 4,607,140). Psychological distress was associated with pain in non-pregnant/non-breastfeeding women (p < 0.001). High-to-very high distress was seen in 26.4% (95% CI, 23.2-29.6) of NP/NBF, 8.1% (95% CI, 0-17.2) of breastfeeding and 7.3% (95% CI, 0-18.0) of pregnant women with moderate-to-very severe pain. Self-rated health status was associated with pain severity in pregnant (p = 0.001) and non-pregnant/non-breastfeeding (p < 0.001) women.

Conclusion: Given the strong association between psychological distress and pain in non-pregnant/non-breastfeeding women, and the relatively common occurrence of moderate-to-very severe pain in both pregnant and breastfeeding women, assessment of psychological distress levels in all women of reproductive age who report experiencing moderate-to-very severe levels of pain may be of benefit.