Abstract
ObjectivesTo compare scores on the 36‐item WHO Disability Assessment Schedule 2.0 tool (WHODAS‐36) for postpartum women across a continuum of morbidity and to validate the 12‐item version (WHODAS‐12).MethodsThis is a secondary analysis of the Brazilian retrospective cohort study on long‐term repercussions of severe maternal morbidity. We determined mean, median, and percentile values for WHODAS‐36 total score and for each domain, and percentile values for WHODAS‐12 total score in postpartum women divided into three groups: “no,” “nonsevere,” and “severe” morbidities.ResultsThe WHODAS‐36 mean total scores were 11.58, 18.31, and 19.19, respectively for no, nonsevere, and severe morbidity. There was a dose‐dependent effect on scores for each domain of WHODAS‐36 according to the presence and severity of morbidity. The diagnostic validity of WHODAS‐12 was determined by comparing it with WHODAS‐36 as a “gold standard.” The best cut‐off point for diagnosing dysfunctionality was the 95th percentile.ConclusionThe upward trend of WHODAS‐36 total mean value scores of women with no morbidity compared with those with morbidity along a severity continuum may reflect the impact of morbidity on postpartum functioning.
Highlights
Progress in maternal health and the consequent reduction in maternal mortality are considered important goals worldwide, as part of the fifth Millennium Development Goal and, presently, of the third Sustainable Development Goal.[1,2] Since the 1990s, there has been significant improvement in maternal and perinatal health indicators, with a decline of about 50% in the overall maternal mortality rate.[3]
This is a secondary analysis of the Brazilian Cohort on Severe Maternal Morbidity (COMMAG)—a retrospective cohort study that included women who delivered between July 1, 2008, and June 30, 2012, at the Women’s Hospital of the University of Campinas, Brazil
As a result of successful efforts to decrease maternal mortality, more women than ever are surviving childbirth, and that well-being is understood as a broad spectrum, it is relevant to understand women’s functioning during pregnancy and the postpartum period, and the impact of morbidities in causing reduced function
Summary
Progress in maternal health and the consequent reduction in maternal mortality are considered important goals worldwide, as part of the fifth Millennium Development Goal and, presently, of the third Sustainable Development Goal.[1,2] Since the 1990s, there has been significant improvement in maternal and perinatal health indicators, with a decline of about 50% in the overall maternal mortality rate.[3]. There are still many challenges to ascertain women’s health and well-being during pregnancy and the postpartum period, even among those women with no medical complications, especially in low-and middle-income countries. The postpartum period is characterized by multiple concerns involving self-confidence, mother–infant interaction, body image experiences, adjustment to maternal roles, and attitudes.[8] These concerns—which are dependent on the presence or diagnosis of morbidity, and on the inadequate assessment of such issues or even their misinterpretation—may contribute to the deterioration of maternal and newborn health.[9]
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