Postnatal morbidity after childbirth and severe obstetric morbidity.
OBJECTIVE
To identify the impact of pregnancy and childbirth, and severe obstetric morbidity on outcome 6 to 12 months postpartum.


METHODS
Questionnaire assessment of postnatal outcome in a cohort study.


METHODS
South East Thames, UK.


METHODS
All women resident in South East Thames and delivering between 1st March 1997 and 28th February 1998.


METHODS
Questionnaire study of a cohort of women who experienced a severe obstetric morbidity during pregnancy or labour (cases), compared with a cohort of women who did not (controls).


METHODS
Assessment of postnatal depression risk [Edinburgh Postnatal Depression Scale (EPDS)], general health [Short Form 36 (SF-36)], sexual activity and use of health services between 6 and 12 months postpartum.


RESULTS
There were 331 cases and 1339 controls out of 48,262 deliveries. Six to 12 months after delivery, 77 (23.3%) of cases and 272 (20.5%) of the controls were at risk of postnatal depression (P = 0.25; 95% CI for difference -2.2% to 7.9%), 43.1% of cases were having problems with sexual relations compared with 18.7% of controls (P < 0.001; 95% CI for difference 8.9% to 21.9%). There was evidence of poorer general health in cases. Some 31.5% of cases attended outpatients in the first six months and 9.4% required emergency admission to hospital compared with 17.0% (P < 0.001; 95% CI for difference 9.1% to 19.9%) and 3.7% (P < 0.001; 95% CI for difference 2.4% to 9.0%), respectively, in controls.


CONCLUSIONS
Both control pregnancy and childbirth and severe obstetric morbidity are associated with significant postnatal morbidity. A severe obstetric morbid event significantly influences women's sexual health and wellbeing and increases health services utilisation. Prevention and appropriate management of severe obstetric morbid events may reduce these outcomes.
Waterstone
Mark
M
Department of Public Health Medicine, GKT School of Medicine and Dentistry, London, UK.
Wolfe
Charles
C
Hooper
Richard
R
Bewley
Susan
S
D016022:Case-Control Studies; D015331:Cohort Studies; D019052:Depression, Postpartum / Q000209:etiology; D005260:Female; D005313:Fetal Death; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires