{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T03:04:29Z","timestamp":1764817469173,"version":"3.46.0"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pregnancy"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sexual abuse before the age of 10 is reported by 2.7% of US women. Chronic pain has been linked to sexual abuse, but little is known about acute postoperative pain in those with a sexual abuse history and no history of chronic pain. We hypothesized that those who report prepubertal sexual abuse experience more pain at 7 days after hospital discharge from a cesarean delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate whether patients who report prepubertal sexual abuse experience more pain 7 days after hospital discharge from a cesarean delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Secondary analysis of a multicenter randomized trial of individuals who underwent cesarean at 31 US hospitals (2020\u20132022). Participants were excluded if they had chronic pain or were missing sexual abuse data. The primary outcome was moderate\u2010to\u2010severe worst pain (\u22654 on a scale from 0 to 10), as assessed by the Brief Pain Inventory (BPI), 7 days after discharge. Secondary outcomes included BPI at 2\u00a0weeks post\u2010discharge and 6\u00a0weeks and 90 days postpartum, Pain Catastrophizing Scale (PCS) and Physical Function (PF) scores at 6\u00a0weeks, Milligram Morphine Equivalents (MME) use in 24\u00a0h before discharge, and opioid use measured at 90 days (number of prescriptions beyond discharge and total number of tablets taken after discharge). Maternal characteristics were compared between those with and without prepubertal sexual abuse. Multivariable modeling was performed adjusting for prepregnancy body mass index (BMI), family history of substance use disorders, and Edinburgh depression score \u226513 at randomization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 4881 participants included in the analysis, 5.3% reported prepubertal sexual abuse. They were significantly more likely to have a BMI \u226530 (54% vs. 44%), a family history of substance use disorders (58% vs. 24%), and an Edinburgh depression score \u2265 13 (9% vs. 4%) (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). Multivariable models showed that a BPI score \u2265 4 was significantly higher 7 days post\u2010discharge (75% vs. 57%; adjusted relative risk [aRR], 1.3 [1.2, 1.4]) in those reporting prepubertal sexual abuse. BPI scores remained significantly higher through 6\u00a0weeks (2 weeks: 42% vs. 30%; aRR, 1.3 [1.1, 1.6]; 6 weeks: 14% vs. 10%; aRR, 1.5 [1.01, 2.1]; 90 days: 5% vs. 5%; aRR, 0.9 [0.4, 1.8]). PCS score \u2265 12 (15% vs. 12%) and PF score below average (64% vs. 56%) were not significantly different at 6\u00a0weeks. Opioid use in the 24\u00a0h before discharge (median MME 22.5% vs. 15,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.01), additional opioid prescriptions after discharge (10% vs. 6%; aRR, 1.7 [1.1, 2.5]), and median total opioid tabs used after discharge (9% vs. 4 tabs,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.01) were all significantly higher among individuals reporting prepubertal sexual abuse.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In postpartum individuals who reported prepubertal sexual abuse, post\u2010cesarean pain through 6\u00a0weeks and prescription opioid use were significantly higher. These associations warrant further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70178","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T05:29:30Z","timestamp":1763443770000},"source":"Crossref","is-referenced-by-count":0,"title":["Childhood sexual abuse and post\u2010cesarean pain"],"prefix":"10.1002","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1489-9190","authenticated-orcid":false,"given":"Jennifer L.","family":"Bailit","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trisha M.","family":"Boekhoudt","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology George Washington University Biostatistics Center Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8504-6715","authenticated-orcid":false,"given":"Kara M.","family":"Rood","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Ohio State University Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcela C.","family":"Smid","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Utah Health Sciences Center Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sindhu K.","family":"Srinivas","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Pennsylvania Philadelphia Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hyagriv N.","family":"Simhan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian M.","family":"Casey","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Alabama at Birmingham Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Longo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology National Institute of Child Health and Human Development Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruth","family":"Landau","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Columbia University New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Bartholomew","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Ohio State University Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amber","family":"Sowles","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Utah Health Sciences Center Salt Lake City Utah USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dwight J.","family":"Rouse","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Brown University Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M. Thorp","family":"Jr","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of North Carolina at Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uma","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Columbia University New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George R.","family":"Saade","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Texas Medical Branch Galveston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suneet P.","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William A.","family":"Grobman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Northwestern University Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cora","family":"MacPherson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology George Washington University Biostatistics Center Washington District of Columbia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal\u2010Fetal Medicine Units (MFMU) Network","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"volume-title":"The National Intimate Partner and Sexual Violence Survey (NISVS): 2015 Data Brief\u2014Updated Release","year":"2018","author":"Smith S. 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