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Chronobiology International
Article . 2014 . Peer-reviewed
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The influence of women’s attachment style on the chronobiology of labour pain, analgesic consumption and pharmacological effect

Authors: Costa-Martins, JM; Pereira, M; Martins, H; Moura-Ramos, M; Coelho, R; Tavares, J;

The influence of women’s attachment style on the chronobiology of labour pain, analgesic consumption and pharmacological effect

Abstract

Circadian variation in biological rhythms has been identified as affecting both labour pain and the pharmacological properties of analgesics. In the context of pain, there is also a growing body of evidence suggesting the importance of adult attachment. The purpose of this study was to examine whether labour pain, analgesic consumption and pharmacological effect are significantly affected by the time of day and to analyse whether this circadian variation is influenced by women's attachment style. This prospective observational study included a sample of 81 pregnant women receiving patient-controlled epidural analgesia (PCEA). Attachment was assessed with the Adult Attachment Scale - Revised. The perceived intensity of labour pain in the early stage of labour (3 cm of cervical dilatation and before the administration of PCEA) was measured using a visual analogue scale (VAS). Pain was also indirectly assessed by measuring the consumption of anaesthetics. The latency period and the duration of effect were recorded for a chronopharmacology characterisation. Pain, as assessed with the VAS, was significantly higher in the night-time group than in the daytime group. An insecure attachment style was significantly associated with greater labour pain at 3 cm of cervical dilatation (p < 0.001) and before the beginning of analgesia (p < 0.001) as well as with higher analgesic consumption and lower pharmacological efficacy (p < 0.05). The time of day was significantly associated with the pharmacological effect: the latency period was longer at night, and the duration of the pharmacological effect was longer during the daytime. The interaction between time of day and attachment style was not significant for any of the study variables. Our results provide evidence of the importance of circadian variation in studying labour pain and the pharmacological effect of labour analgesia involving epidural blockage with a PCEA regimen. Moreover, although there was no evidence that attachment style influenced the circadian variation, these data emphasise that insecure attachment patterns are a risk factor for greater labour pain and analgesic consumption, which should be considered in pain management approaches.

Country
Portugal
Keywords

Adult, Pain Threshold, Time Factors, Emotions, Analgesia, Epidural*, Labor Pain / drug therapy*, Pain Perception / drug effects*, MAC ANS, Young Adult, Pregnancy, Labor Pain / diagnosis, Reaction Time, Humans, Prospective Studies, Pain Measurement, Labor Pain, Analgesics, Circadian Rhythm*, Reaction Time / drug effects, Analgesia, Patient-Controlled, Pain Perception, Analgesics / administration & dosage*, Fear, Middle Aged, Pain Threshold / drug effects*, Circadian Rhythm, Analgesia, Epidural, Female, Labor Pain / psychology

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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OpenAIRE UsageCountsViews provided by UsageCounts
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