BACKGROUND:
Representative data on persistent pain after vaginal birth are lacking.

OBJECTIVES:
This study aimed to assess the prevalence and risk factors for persistent genito-pelvic pain two months after vaginal birth using population-based data.

METHODS:
Data were obtained from the 2021 National Perinatal Survey, a French nationwide cross-sectional population-based survey. The study population included women who delivered vaginally. The main outcome was persistent genito-pelvic pain at two months postpartum collected by a self-reported questionnaire. Prevalence rates with 95% confidence intervals (CI) were estimated overall and by the severity of perineal tear. Risk factors were identified using univariable and multivariable logistic regression. All analyses were weighted to account for 2-month attrition.

RESULTS:
This study included 5,802 women who delivered vaginally. The overall prevalence of persistent genito-pelvic pain at 2 months postpartum was 12.8% (95%CI [11.8-13.8%]), ranging from 5.9% (95%CI [4.3-7.9%]) in women with an intact perineum to 38.9% (95%CI [27.1-52.2]) in those with obstetric anal sphincter injury (OASI). In multivariable analyses, all degrees of perineal tear were associated with an increased risk of persistent genito-pelvic pain compared with intact perineum (1st/2nd degree, aOR 2.08; 95%CI [1.51-2.87]; episiotomy: 3.37 [2.27-4.99] and OASI: 5.92 [3.03-11.55]). Other risk factors included being born in Africa (1.51 [1.06-2.16]), primiparity (1.50 [1.20-1.87]), poor maternal psychological state during pregnancy (2.05 [1.48-2.83]), operative birth (1.43 [1.14-1.79]), negative childbirth experience (2.03 [1.50-2.77]), and dissatisfaction with pain management during the stay in maternity unit (somewhat satisfied: 1.59 [1.28-1.98]; and not very or not satisfied: 3.11 [2.27-4.26]).

CONCLUSIONS:
Persistent genito-pelvic pain at two months postpartum affects 1 in 10 women and increases with the severity of perineal injury.

KEY MESSAGE:
To reduce this pain, it is necessary to prevent perineal lesions and operative births as much as possible, while improving women's satisfaction during their maternity stay, probably by optimizing postpartum analgesic management. Poster session 1 (Group A)