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The impact of hypertension, hemorrhage, and other maternal morbidities on functioning in the postpartum period as assessed by the WHODAS 2.0 36‐item tool
Author(s) -
Guida José P.,
Costa Maria L.,
Parpinelli Mary A.,
Pacagnella Rodolfo C.,
Ferreira Elton C.,
Mayrink Jussara,
Silveira Carla,
Souza Renato T.,
Sousa Maria H.,
Say Lale,
Chou Doris,
Filippi Veronique,
Barreix Maria,
Barbour Kelli,
McCawBinns Affette,
Dadelszen Peter,
Cecatti José G.
Publication year - 2018
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1002/ijgo.12467
Subject(s) - medicine , percentile , pregnancy , postpartum period , retrospective cohort study , cohort , childbirth , obstetrics , complication , pediatrics , statistics , genetics , mathematics , biology
Objective To assess the scores of postpartum women using the WHO Disability Assessment Schedule 2.0 36‐item tool ( WHODAS ‐36), considering different morbidities. Methods Secondary analysis of a retrospective cohort of women who delivered at a referral maternity in Brazil and were classified with and without severe maternal morbidity ( SMM ). WHODAS ‐36 was used to assess functioning in postpartum women. Percentile distribution of total WHODAS score was compared across three groups: Percentile (P)<10, 1090. Cases of SMM were categorized and WHODAS ‐36 score was assessed according to hypertension, hemorrhage, or other conditions. Results A total of 638 women were enrolled: 64 had mean scores below P<10 (1.09) and 66 were above P>90 (41.3). Of women scoring above P>90, those with morbidity had a higher mean score than those without (44.6% vs 36.8%, P =0.879). Women with higher WHODAS ‐36 scores presented more complications during pregnancy, especially hypertension (47.0% vs 37.5%, P =0.09). Mean scores among women with any complication were higher than those with no morbidity (19.0 vs 14.2, P =0.01). WHODAS ‐36 scores were higher among women with hypertensive complications (19.9 vs 16.0, P =0.004), but lower among those with hemorrhagic complications (13.8 vs 17.7, P =0.09). Conclusions Complications during pregnancy, childbirth, and the puerperium increase long‐term WHODAS ‐36 scores, demonstrating a persistent impact on functioning among women, up to 5 years postpartum.