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Research article
Maria Laura Costa
Universidade Estadual de Campinas
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8280-3234
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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 factors associated to impaired clinical, social and mental health conditions.
Method: A cross-sectional study with postpartum women at a high-risk outpatient clinic in southeast Brazil, from November 2017 to December 2018. 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- impaired if ≥10), functionality (WHODAS- high disability scores when ≥37.4) and data on violence and substance use. Subsequently, an evaluation of cases with positive findings was performed, with a Poisson regression to investigate factors associated to impaired non-clinical and clinical conditions.
Results: 517 women were included, majority (54.3%) multiparous, between 20 and 34 years (65.4%) and with a partner (75,6%). Over a quarter had (26.2%) preterm birth. 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 use and 5.9% reported exposure to violence. Anxiety was identified in 19.8% of cases, depression in 36.9% and impaired functioning in 4.4% of women. Poisson regression identified that poor overall health rating was associated to increased anxiety/depression and impaired functioning. Having a partner reduced perception of women on the presence of clinical morbidities.
Conclusion: During postpartum care of a high-risk population, over one third of the considered women presented anxiety and depression; 10% reported substance use and around 6% exposure to violence. These aspects of women´s health need further evaluation and specific interventions to improve quality of care.
Keywords
Maternal Morbidity, mental health, functionality, depression, puerperium, WHODAS 2.0, PHQ-9, GAD-7.
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CURRENT STATUS: Published
View the published article at BMC Pregnancy and Childbirth.
Version 3
Posted 15 Jan, 2021
No community comments so far
Editorial decision: Minor revision
On 31 Jan, 2021
Review #1 received
Received 17 Jan, 2021
Reviewer #1 agreed
On 16 Jan, 2021
Reviewers invited
Invitations sent on 12 Jan, 2021
Editor assigned
On 06 Jan, 2021
Submission checks complete
On 06 Jan, 2021
Editor invited
On 06 Jan, 2021
No comments provided
Editorial decision: Major revision
On 19 Nov, 2020
Review #1 received
Received 16 Nov, 2020
Reviewer #1 agreed
On 07 Nov, 2020
Editor assigned
On 04 Nov, 2020
Reviewers invited
Invitations sent on 04 Nov, 2020
Submission checks complete
On 04 Nov, 2020
Editor invited
On 04 Nov, 2020
No comments provided
Editorial decision: Major revision
On 09 Oct, 2020
Review #1 received
Received 05 Aug, 2020
Reviewer #1 agreed
On 20 Jul, 2020
Reviewers invited
Invitations sent on 18 Jun, 2020
Submission checks complete
On 07 May, 2020
Editor assigned
On 06 May, 2020
Editor invited
On 05 May, 2020
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Subject Areas
Maternal & Fetal Medicine
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A new preprint design is coming!
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See the published version of this preprint at BMC Pregnancy and Childbirth.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Maria Laura Costa
Universidade Estadual de Campinas
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8280-3234
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Pregnancy and Childbirth.
Version 3
Posted 15 Jan, 2021
No community comments so far
Editorial decision: Minor revision
On 31 Jan, 2021
Review #1 received
Received 17 Jan, 2021
Reviewer #1 agreed
On 16 Jan, 2021
Reviewers invited
Invitations sent on 12 Jan, 2021
Editor assigned
On 06 Jan, 2021
Submission checks complete
On 06 Jan, 2021
Editor invited
On 06 Jan, 2021
No comments provided
Editorial decision: Major revision
On 19 Nov, 2020
Review #1 received
Received 16 Nov, 2020
Reviewer #1 agreed
On 07 Nov, 2020
Editor assigned
On 04 Nov, 2020
Reviewers invited
Invitations sent on 04 Nov, 2020
Submission checks complete
On 04 Nov, 2020
Editor invited
On 04 Nov, 2020
No comments provided
Editorial decision: Major revision
On 09 Oct, 2020
Review #1 received
Received 05 Aug, 2020
Reviewer #1 agreed
On 20 Jul, 2020
Reviewers invited
Invitations sent on 18 Jun, 2020
Submission checks complete
On 07 May, 2020
Editor assigned
On 06 May, 2020
Editor invited
On 05 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Pregnancy and Childbirth.
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 factors associated to impaired clinical, social and mental health conditions.
Method: A cross-sectional study with postpartum women at a high-risk outpatient clinic in southeast Brazil, from November 2017 to December 2018. 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- impaired if ≥10), functionality (WHODAS- high disability scores when ≥37.4) and data on violence and substance use. Subsequently, an evaluation of cases with positive findings was performed, with a Poisson regression to investigate factors associated to impaired non-clinical and clinical conditions.
Results: 517 women were included, majority (54.3%) multiparous, between 20 and 34 years (65.4%) and with a partner (75,6%). Over a quarter had (26.2%) preterm birth. 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 use and 5.9% reported exposure to violence. Anxiety was identified in 19.8% of cases, depression in 36.9% and impaired functioning in 4.4% of women. Poisson regression identified that poor overall health rating was associated to increased anxiety/depression and impaired functioning. Having a partner reduced perception of women on the presence of clinical morbidities.
Conclusion: During postpartum care of a high-risk population, over one third of the considered women presented anxiety and depression; 10% reported substance use and around 6% exposure to 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.
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