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Prenatal quantitative sensory testing parameters are linked with the emotional—but not sensory—dimensions of labor pain, linking lower thermal pain thresholds to greater distress from pain.
A new study exploring the psychophysical correlates of labor pain intensity and unpleasantness has yielded fresh insights into how prenatal sensory processing may influence the emotional dimensions of childbirth pain. The findings suggest that quantitative sensory testing (QST) conducted during pregnancy could help identify women at risk for heightened emotional distress and potential postpartum mood complications.
While labor pain is one of the most intense physiological experiences, its emotional unpleasantness varies widely among individuals. Researchers have long suspected that emotional aspects of labor pain—distinct from its physical intensity—are modulated by limbic system pathways also involved in mood regulation. However, the neurobiological mechanisms connecting perinatal pain and mood disturbances remain poorly understood. Hence, Lee-Kai Sun et al. enrolled healthy primiparous females and followed them from the third trimester through delivery.
Using prenatal QST, investigators assessed each participant’s mechanical and thermal pain thresholds, tolerance levels, and temporal summation responses. During labor, volunteers recorded their pain intensity and unpleasantness hourly via a validated electronic diary. Out of 164 women who completed QST assessments, 55 provided complete labor pain diaries, allowing researchers to analyze the link between prenatal sensory data and labor pain experiences. Univariable linear regression was applied to evaluate these associations.
The results revealed a noteworthy connection between prenatal QST parameters and the emotional aspects of labor pain, but not with the sensory intensity. Specifically:
These findings indicate that women with lower thermal pain thresholds and evidence of central sensitization may experience labor as more emotionally unpleasant—even if the sensory intensity of the pain remains similar. By identifying women with heightened emotional pain sensitivity before labor, clinicians may be able to personalize pain management strategies and offer targeted psychological support.
Journal of Psychosomatic Obstetrics & Gynecology
Psychophysical correlates of labor pain intensity and unpleasantness
Lee-Kai Sun et al.
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