A Multicenter Assessment of Postpartum Recovery Using the STanford Obstetric Recovery Checklist.
Outpatient postpartum recovery remains poorly understood. We aimed to characterize postpartum recovery and compare recovery by delivery mode and parity using with the newly validated STanford Obstetric Recovery checKlist (STORK).
Following institutional review board approval, English-speaking adults were recruited from three U.S. academic centers. Demographic and clinical data were collected. Participants completed STORK (47 items covering physical, mental/emotional health, motherhood experience/social support, sleep/fatigue domains), at two, six and 12 weeks postpartum. Chi-square, one-way ANOVA, and Kruskal-Wallis tests were used to compare categorical and continuous variables.
A total of 498 participants were included (Asian 15%, Black 8%, White 51%), mean age 33±5years. Median gestational age was 39 weeks (IQR 2), and 46% were primiparous. Spontaneous/induced vaginal delivery (SVD), scheduled cesarean delivery (CD), non-scheduled CD, and operative vaginal delivery (OVD) represented 52%, 27%, 18% and 3% of participants, respectively. Total STORK, physical health, and sleep/fatigue scores improved from inpatient postpartum period to week 12 postpartum (P<0·001) for all delivery modes, with a 22% increase in median total scores. Mental health and motherhood experience scores improved until week six (P<0·001). Physical recovery scores differed significantly between delivery modes, with best scores after SVD and lowest after OVD up to week two. Overall recovery was better in multiparous compared to primiparous patients up to six weeks postpartum, though differences resolved by week 12.
Postpartum recovery continues through 12 weeks and varies by delivery mode and parity. Future studies are needed to determine clinically meaningful differences to inform thresholds for targeted interventions.
Following institutional review board approval, English-speaking adults were recruited from three U.S. academic centers. Demographic and clinical data were collected. Participants completed STORK (47 items covering physical, mental/emotional health, motherhood experience/social support, sleep/fatigue domains), at two, six and 12 weeks postpartum. Chi-square, one-way ANOVA, and Kruskal-Wallis tests were used to compare categorical and continuous variables.
A total of 498 participants were included (Asian 15%, Black 8%, White 51%), mean age 33±5years. Median gestational age was 39 weeks (IQR 2), and 46% were primiparous. Spontaneous/induced vaginal delivery (SVD), scheduled cesarean delivery (CD), non-scheduled CD, and operative vaginal delivery (OVD) represented 52%, 27%, 18% and 3% of participants, respectively. Total STORK, physical health, and sleep/fatigue scores improved from inpatient postpartum period to week 12 postpartum (P<0·001) for all delivery modes, with a 22% increase in median total scores. Mental health and motherhood experience scores improved until week six (P<0·001). Physical recovery scores differed significantly between delivery modes, with best scores after SVD and lowest after OVD up to week two. Overall recovery was better in multiparous compared to primiparous patients up to six weeks postpartum, though differences resolved by week 12.
Postpartum recovery continues through 12 weeks and varies by delivery mode and parity. Future studies are needed to determine clinically meaningful differences to inform thresholds for targeted interventions.
Authors
Takenoshita Takenoshita, Guo Guo, Carvalho Carvalho, Leonard Leonard, Panelli Panelli, Farber Farber, Toledo Toledo, Higgins Higgins, Sultan Sultan
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