Refining the prediction of multisite pain in 13-year-old boys and girls by using parent-reported pain experiences in the first decade of life

Autores da FMUP

• Raquel Lucas Calado Ferreira

  Autor

Participantes de fora da FMUP

• Brandao, M
• Gorito, V
• Talih, M

Unidades de investigação

• Ciências da Saúde Pública e Forenses, e Educação Médica

Abstract

Background We evaluated different pain profiles as prospective predictors of multisite pain in 13-year-old adolescents (1300 girls and 1457 boys) enrolled in Generation XXI, a birth cohort study in Portugal. Methods Pain history was queried using the Luebeck Pain Questionnaire through parent proxy- (ages 7 and 10) and adolescent (age 13) self-reports. We estimated the risk of multisite pain (2 or more pain sites) at age 13, according to previous pain experiences, including accumulation and timing. We defined five profiles that combined adverse features at ages 7 and 10 (recurrence, multisite, frequency, duration, intensity, triggers, activity restrictions, passive coping, and family history) and estimated their relative risks (RR) and likelihood ratios (LR) for adolescent multisite pain. Results At age 13, 39.2% of girls and 27.2% of boys reported multisite pain in the previous three months. The risk was higher among girls with multisite and recurrent pain at ages 7 and 10 than in girls without those adverse features, especially if psychosocial triggers were also present (RR 1.87; 95% confidence interval 1.36, 2.36 and LR 3.49; 1.53, 7.96). Boys with recurrent pain of higher frequency and causing activity restrictions at ages 7 and 10 had a higher risk of multisite pain at 13 (RR 2.05; 1.03, 3.05 and LR 3.06; 1.12, 8.39). Earlier adverse experiences were more predictive of future pain in girls than in boys. Conclusions Different profiles were useful to rule in future multisite pain in boys and girls. This provides clues for early stratification of chronic pain risk. Significance We identified sex-specific pain features that can be collected by practitioners in the first decade of life to improve the stratification of children in terms of their future risk of a maladaptive pain experience in adolescence. Using a prospective population-based cohort design, we show that early multisite pain and psychosocial triggers are relevant predictors of future multisite pain in girls, whereas repeated reports of high-frequency pain leading to activity restrictions are predictive of adolescent multisite pain in boys.

Keywords

• LOW-BACK-PAIN; MUSCULOSKELETAL PAIN; SEX-DIFFERENCES; RECURRENT PAIN; RISK-FACTORS; FOLLOW-UP; ADOLESCENTS; CHILDREN; TRAJECTORIES; POPULATION