title: Functional status of women with and without severe maternal morbidity: A prospective cohort study.
abstract: BACKGROUND
  Little is known regarding the impact on maternal functional status in women who have survived severe obstetric complications.
  
  
  OBJECTIVE
  To compare the maternal functional status score between women with and without severe morbidity at one month and six months postpartum in Kelantan, Malaysia.
  
  
  METHODS
  A prospective cohort study design was applied at two tertiary referral hospitals over a six-month period. The study population included all postpartum women who gave birth in 2014. Postpartum women with severe maternal morbidity and without severe maternal morbidity were selected as the exposed and non-exposed group, respectively. Functional ability based on the Inventory of Functional Status after Childbirth was used as the main outcome measure. Repeated measure analysis of variance was performed.
  
  
  RESULTS
  A total of 145 and 187 women with and without severe maternal morbidity, respectively, were measured. There were significant differences in Inventory of Functional Status after Childbirth score changes (P<0.001) between women with and without severe maternal morbidity at one month and at six months. Functional ability score of women with severe maternal morbidity was lower at one month postpartum (P=0.001). The most affected domain was infant care (P=0.002).
  
  
  CONCLUSIONS
  Healthcare providers are recommended to assess the short-term functional ability of severe morbid mother in addition to existing routine physical examination. Provision of physical support from spouse and family of the high risk mothers particularly on infant care during their early postpartum period is crucial to optimise health and minimise the negative health outcomes.
authors.affiliation: Women's Health Development Unit, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia. Electronic address: hayatikk@usm.my.
authors.forename: Mohd Noor
authors.initials: MN
authors.lastname: Norhayati
authors.affiliation: Women's Health Development Unit, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Kelantan, Malaysia.
authors.forename: Nik Hussain
authors.initials: NH
authors.lastname: Nik Hazlina
authors.affiliation: Faculty of Medicine, Health Campus, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia.
authors.forename: Abd Aziz
authors.initials: AA
authors.lastname: Aniza
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D008296:Malaysia / Q000453:epidemiology; D008428:Maternal Mortality; D009017:Morbidity; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D036801:Parturition; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011446:Prospective Studies; D012720:Severity of Illness Index
keywords: Functional ability; Inventory of Functional Status after Childbirth; Prospective cohort; Severe maternal morbidity; Severe obstetric complications