Background
There are no accurate estimates of the prevalence of non-severe maternal morbidities. Given the lack of instruments to fully assess these morbidities, the World Health Organization (WHO) developed an instrument called WOICE.
Objective
To evaluate the prevalence of non-severe maternal morbidities in puerperal women and analyses factors associated to impaired clinical, social and mental health conditions.
Method
A cross-sectional study with 519 postpartum women in a single encounter 6 to 12 weeks postpartum. The WOICE questionnaire included three sections: the first with maternal and obstetric history, sociodemographic data, risk and environment factors, violence and sexual health; The second considers functionality and disability, general symptoms and mental health; and the third includes data on physical and laboratory tests. Data collection was supported by Tablets with REDCAP software. Initially, a descriptive analysis was performed, with general prevalence of all variables contained in the WOICE, including scales on anxiety and depression (GAD-7 and PHQ-9- altered if ≥ 10), functionality (WHODAS- altered when ≥ 37.4) and data on violence and substance use. Subsequently, an evaluation of cases with alterations was performed, with a logistic regression to investigate factors associated to impaired non-clinical and clinical conditions.
Results
517 women were included, majority (54.3%) multiparous, ages between 20 and 34 years (65.4%) and with partner (75,6%). Over a quarter had (26.2%) preterm birth, however good perinatal outcomes. Around a third (30.2%) reported health problems informed by the physician, although more than 80% considered having good or very good health. About 10% reported any substance and 5.9% suffered violence. Anxiety was identified in 19.8% of cases, depression in 36.9% and altered functioning in 4.4% of women. Logistic regression identified that poor overall health rating was associated to increased anxiety/depression and impaired functioning. Having a partner reduces the perception of women on the presence of clinical morbidities.
Conclusion
During postpartum care, women presented high frequency of anxiety and depression and relevant frequency of substance use and violence. These aspects of women´s health need further evaluation and specific interventions to improve quality of care.

Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
Loading...
On 31 Jan, 2021
Received 17 Jan, 2021
On 16 Jan, 2021
Invitations sent on 12 Jan, 2021
On 06 Jan, 2021
On 06 Jan, 2021
On 06 Jan, 2021
On 19 Nov, 2020
Received 16 Nov, 2020
On 07 Nov, 2020
On 04 Nov, 2020
Invitations sent on 04 Nov, 2020
On 04 Nov, 2020
On 04 Nov, 2020
Posted 12 May, 2020
On 09 Oct, 2020
Received 05 Aug, 2020
On 20 Jul, 2020
Invitations sent on 18 Jun, 2020
On 07 May, 2020
On 06 May, 2020
On 05 May, 2020
On 31 Jan, 2021
Received 17 Jan, 2021
On 16 Jan, 2021
Invitations sent on 12 Jan, 2021
On 06 Jan, 2021
On 06 Jan, 2021
On 06 Jan, 2021
On 19 Nov, 2020
Received 16 Nov, 2020
On 07 Nov, 2020
On 04 Nov, 2020
Invitations sent on 04 Nov, 2020
On 04 Nov, 2020
On 04 Nov, 2020
Posted 12 May, 2020
On 09 Oct, 2020
Received 05 Aug, 2020
On 20 Jul, 2020
Invitations sent on 18 Jun, 2020
On 07 May, 2020
On 06 May, 2020
On 05 May, 2020
Background
There are no accurate estimates of the prevalence of non-severe maternal morbidities. Given the lack of instruments to fully assess these morbidities, the World Health Organization (WHO) developed an instrument called WOICE.
Objective
To evaluate the prevalence of non-severe maternal morbidities in puerperal women and analyses factors associated to impaired clinical, social and mental health conditions.
Method
A cross-sectional study with 519 postpartum women in a single encounter 6 to 12 weeks postpartum. The WOICE questionnaire included three sections: the first with maternal and obstetric history, sociodemographic data, risk and environment factors, violence and sexual health; The second considers functionality and disability, general symptoms and mental health; and the third includes data on physical and laboratory tests. Data collection was supported by Tablets with REDCAP software. Initially, a descriptive analysis was performed, with general prevalence of all variables contained in the WOICE, including scales on anxiety and depression (GAD-7 and PHQ-9- altered if ≥ 10), functionality (WHODAS- altered when ≥ 37.4) and data on violence and substance use. Subsequently, an evaluation of cases with alterations was performed, with a logistic regression to investigate factors associated to impaired non-clinical and clinical conditions.
Results
517 women were included, majority (54.3%) multiparous, ages between 20 and 34 years (65.4%) and with partner (75,6%). Over a quarter had (26.2%) preterm birth, however good perinatal outcomes. Around a third (30.2%) reported health problems informed by the physician, although more than 80% considered having good or very good health. About 10% reported any substance and 5.9% suffered violence. Anxiety was identified in 19.8% of cases, depression in 36.9% and altered functioning in 4.4% of women. Logistic regression identified that poor overall health rating was associated to increased anxiety/depression and impaired functioning. Having a partner reduces the perception of women on the presence of clinical morbidities.
Conclusion
During postpartum care, women presented high frequency of anxiety and depression and relevant frequency of substance use and violence. These aspects of women´s health need further evaluation and specific interventions to improve quality of care.

Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
Loading...