{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T13:08:05Z","timestamp":1790341685591,"version":"4.1.0"},"reference-count":37,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006521","name":"Stanford University School of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006521","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100005492","name":"Stanford University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005492","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjaopen.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["BJA Open"],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.1016\/j.bjao.2026.100560","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T04:09:44Z","timestamp":1777608584000},"page":"100560","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":2,"special_numbering":"C","title":["Biopsychosocial predictors of chronic pain after Caesarean delivery: a prospective cohort evaluation of the SPACE (Sleep, Pain, Affect, Cognition, Energy)-Postpartum framework"],"prefix":"10.1016","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5906-1797","authenticated-orcid":false,"given":"Sarah","family":"Ciechanowicz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermina","family":"Michel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisha","family":"Panigrahy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2224-1992","authenticated-orcid":false,"given":"Hannah","family":"Sukhdeo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan","family":"Carvalho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7770-0289","authenticated-orcid":false,"given":"Pervez","family":"Sultan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.bjao.2026.100560_bib1","doi-asserted-by":"crossref","DOI":"10.1016\/j.jclinane.2025.111832","article-title":"Incidence, Severity, and Interference of Chronic Postsurgical Pain after Cesarean Delivery: A Systematic Review and Meta-analysis","volume":"104","author":"Ciechanowicz","year":"2025","journal-title":"J Clin Anesth"},{"key":"10.1016\/j.bjao.2026.100560_bib2","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1080\/24740527.2019.1574538","article-title":"Caesarean delivery: bringing more than just a bundle of joy","volume":"3","author":"Quinlan","year":"2019","journal-title":"Can J Pain"},{"key":"10.1016\/j.bjao.2026.100560_bib3","doi-asserted-by":"crossref","first-page":"1912","DOI":"10.1097\/j.pain.0000000000002938","article-title":"Predicting chronic postsurgical pain: current evidence and a novel program to develop predictive biomarker signatures","volume":"164","author":"Sluka","year":"2023","journal-title":"Pain"},{"key":"10.1016\/j.bjao.2026.100560_bib4","doi-asserted-by":"crossref","first-page":"2394","DOI":"10.1097\/j.pain.0000000000001917","article-title":"The transition from acute to chronic pain: dynamic epigenetic reprogramming of the mouse prefrontal cortex up to 1 year after nerve injury","volume":"161","author":"Topham","year":"2020","journal-title":"Pain"},{"key":"10.1016\/j.bjao.2026.100560_bib5","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.bja.2022.06.010","article-title":"Towards better predictive models of chronic post-surgical pain: fitting to the dynamic nature of the pain itself","volume":"129","author":"Fletcher","year":"2022","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.bjao.2026.100560_bib6","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.ijoa.2019.06.003","article-title":"Persistent pain after cesarean delivery","volume":"40","author":"Sun","year":"2019","journal-title":"Int J Obstet Anesth"},{"key":"10.1016\/j.bjao.2026.100560_bib7","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.pain.2008.07.011","article-title":"Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression","volume":"140","author":"Eisenach","year":"2008","journal-title":"Pain"},{"key":"10.1016\/j.bjao.2026.100560_bib8","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1111\/aogs.12613","article-title":"Risk factors for persistent pain and its influence on maternal wellbeing after cesarean section","volume":"94","author":"Niklasson","year":"2015","journal-title":"Acta Obstet Gynecol Scand"},{"key":"10.1016\/j.bjao.2026.100560_bib9","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1186\/s12871-016-0270-6","article-title":"Prevalence and risk factors for chronic pain following cesarean section: a prospective study","volume":"16","author":"Jin","year":"2016","journal-title":"BMC Anesthesiol"},{"key":"10.1016\/j.bjao.2026.100560_bib10","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1213\/ANE.0000000000001619","article-title":"Persistent pain after Cesarean delivery and vaginal delivery: a prospective cohort study","volume":"123","author":"Kainu","year":"2016","journal-title":"Anesth Analg"},{"key":"10.1016\/j.bjao.2026.100560_bib11","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.ijoa.2016.10.004","article-title":"Persistent pain after caesarean section and its association with maternal anxiety and socioeconomic background","volume":"29","author":"Daly","year":"2017","journal-title":"Int J Obstet Anesth"},{"key":"10.1016\/j.bjao.2026.100560_bib12","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1186\/s12911-025-03004-9","article-title":"A machine learning\u2013based framework for predicting postpartum chronic pain: a retrospective study","volume":"25","author":"Liu","year":"2025","journal-title":"BMC Med Inform Decis Mak"},{"key":"10.1016\/j.bjao.2026.100560_bib13","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1093\/pm\/pnac171","article-title":"Pain severity and pain interference in late pregnancy: an analysis of biopsychosocial factors among women scheduled for Cesarean delivery","volume":"24","author":"Wilson","year":"2023","journal-title":"Pain Med"},{"key":"10.1016\/j.bjao.2026.100560_bib14","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijoa.2025.104331","article-title":"Chronic pain after cesarean delivery: what do we know today? A narrative review","volume":"62","author":"Langenaeken","year":"2025","journal-title":"Int J Obstet Anesth"},{"key":"10.1016\/j.bjao.2026.100560_bib15","article-title":"SPACE-postpartum: a multidomain biopsychosocial framework for predicting chronic pain and impaired recovery after cesarean delivery - proof-of-concept report","volume":"50","author":"Ciechanowicz","year":"2025","journal-title":"Reg Anesth Pain Med"},{"key":"10.1016\/j.bjao.2026.100560_bib16","article-title":"Patient experiences of chronic postsurgical pain after caesarean delivery: findings from a prospective qualitative study","volume":"65","author":"Ciechanowicz","year":"2025","journal-title":"Int J Obstet Anesth"},{"key":"10.1016\/j.bjao.2026.100560_bib17","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1016\/j.bja.2024.12.009","article-title":"The number of central nervous system-driven symptoms predicts subsequent chronic primary pain: evidence from UK Biobank","volume":"134","author":"Kelleher","year":"2025","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.bjao.2026.100560_bib18","doi-asserted-by":"crossref","first-page":"2002","DOI":"10.1097\/j.pain.0000000000001299","article-title":"Sensory sensitivity and symptom severity represent unique dimensions of chronic pain: a MAPP Research Network study","volume":"159","author":"Schrepf","year":"2018","journal-title":"Pain"},{"key":"10.1016\/j.bjao.2026.100560_bib19","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1002\/sim.7992","article-title":"Minimum sample size for developing a multivariable prediction model: PART II - binary and time-to-event outcomes","volume":"38","author":"Riley","year":"2019","journal-title":"Stat Med"},{"key":"10.1016\/j.bjao.2026.100560_bib20","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1186\/s12874-021-01374-y","article-title":"To tune or not to tune, a case study of ridge logistic regression in small or sparse datasets","volume":"21","author":"\u0160inkovec","year":"2021","journal-title":"BMC Med Res Methodol"},{"key":"10.1016\/j.bjao.2026.100560_bib21","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1016\/S0895-4356(03)00047-7","article-title":"Internal and external validation of predictive models: a simulation study of bias and precision in small samples","volume":"56","author":"Steyerberg","year":"2003","journal-title":"J Clin Epidemiol"},{"key":"10.1016\/j.bjao.2026.100560_bib22","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1186\/s12888-016-1075-3","article-title":"Insomnia and the risk of depression: a meta-analysis of prospective cohort studies","volume":"16","author":"Li","year":"2016","journal-title":"BMC Psychiatry"},{"key":"10.1016\/j.bjao.2026.100560_bib23","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1093\/sleep\/30.7.873","article-title":"Chronic insomnia as a risk factor for developing anxiety and depression","volume":"30","author":"Neckelmann","year":"2007","journal-title":"Sleep"},{"key":"10.1016\/j.bjao.2026.100560_bib24","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1016\/j.cpr.2012.09.009","article-title":"Treatment development: can we find a better way?","volume":"33","author":"Hayes","year":"2013","journal-title":"Clin Psychol Rev"},{"key":"10.1016\/j.bjao.2026.100560_bib25","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/j.outlook.2016.05.008","article-title":"National Institutes of Health Symptom Science Model sheds light on patient symptoms","volume":"64","author":"Cashion","year":"2016","journal-title":"Nurs Outlook"},{"key":"10.1016\/j.bjao.2026.100560_bib26","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1016\/j.bja.2023.02.041","article-title":"Non-opioid analgesics for the prevention of chronic postsurgical pain: a systematic review and network meta-analysis","volume":"130","author":"Doleman","year":"2023","journal-title":"Br J Anaesth"},{"key":"10.1016\/j.bjao.2026.100560_bib27","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1097\/j.pain.0000000000001413","article-title":"The IASP classification of chronic pain for ICD-11: chronic postsurgical or posttraumatic pain","volume":"160","author":"Schug","year":"2019","journal-title":"Pain"},{"key":"10.1016\/j.bjao.2026.100560_bib28","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1186\/1471-2474-10-124","article-title":"Patients\u2019 experiences of living with and receiving treatment for fibromyalgia syndrome: a qualitative study","volume":"10","author":"Lempp","year":"2009","journal-title":"BMC Musculoskelet Disord"},{"key":"10.1016\/j.bjao.2026.100560_bib29","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1097\/AJP.0000000000000286","article-title":"The SPADE symptom cluster in primary care patients with chronic pain","volume":"32","author":"Davis","year":"2016","journal-title":"Clin J Pain"},{"key":"10.1016\/j.bjao.2026.100560_bib30","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.1007\/s12035-018-1130-9","article-title":"Role of the prefrontal cortex in pain processing","volume":"56","author":"Ong","year":"2019","journal-title":"Mol Neurobiol"},{"key":"10.1016\/j.bjao.2026.100560_bib31","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1097\/ALN.0000000000002130","article-title":"Neuroinflammation and central sensitization in chronic and widespread pain","volume":"129","author":"Ji","year":"2018","journal-title":"Anesthesiology"},{"key":"10.1016\/j.bjao.2026.100560_bib32","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2025.5713","article-title":"Development and Validation of the Stanford Obstetric Recovery checKlist (STORK): A Delphi Consensus and Multicenter Clinical Validation Study","volume":"8","author":"Sultan","year":"2025","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.bjao.2026.100560_bib33","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1097\/EJA.0000000000001974","article-title":"Chronic postsurgical pain: A European survey","volume":"41","author":"Martinez","year":"2024","journal-title":"Eur J Anaesthesiol"},{"key":"10.1016\/j.bjao.2026.100560_bib34","doi-asserted-by":"crossref","first-page":"2611","DOI":"10.1097\/j.pain.0000000000001945","article-title":"Presurgical risk model for chronic postsurgical pain based on 6 clinical predictors: a prospective external validation","volume":"161","author":"Montes","year":"2020","journal-title":"Pain"},{"key":"10.1016\/j.bjao.2026.100560_bib35","doi-asserted-by":"crossref","first-page":"657","DOI":"10.12669\/pjms.40.4.8979","article-title":"Construction and validation of chronic pain prediction model after total knee arthroplasty","volume":"40","author":"Qian","year":"2024","journal-title":"Pak J Med Sci"},{"key":"10.1016\/j.bjao.2026.100560_bib36","doi-asserted-by":"crossref","DOI":"10.1155\/2019\/6985164","article-title":"Chronic pain prevalence and exposures during pregnancy","volume":"2019","author":"Ray-Griffith","year":"2019","journal-title":"Pain Res Manag"},{"key":"10.1016\/j.bjao.2026.100560_bib37","series-title":"Clinical Prediction Models: A Practical Approach to Development, Validation, and Updating","author":"Steyerberg","year":"2019"}],"container-title":["BJA Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2772609626000341?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2772609626000341?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T23:06:47Z","timestamp":1782774407000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2772609626000341"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":37,"alternative-id":["S2772609626000341"],"URL":"https:\/\/doi.org\/10.1016\/j.bjao.2026.100560","relation":{},"ISSN":["2772-6096"],"issn-type":[{"value":"2772-6096","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Biopsychosocial predictors of chronic pain after Caesarean delivery: a prospective cohort evaluation of the SPACE (Sleep, Pain, Affect, Cognition, Energy)-Postpartum framework","name":"articletitle","label":"Article Title"},{"value":"BJA Open","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.bjao.2026.100560","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier Ltd on behalf of British Journal of Anaesthesia.","name":"copyright","label":"Copyright"}],"article-number":"100560"}}