Quality of recovery following childbirth: a prospective, multicentre cohort study

J E O'Carroll; L Zucco; E Warwick; G Arbane; S R Moonesinghe; K El-Boghdadly; N Guo; B Carvalho; P Sultan; ObsQoR Collaborators

doi:10.1111/anae.16039

Quality of recovery following childbirth: a prospective, multicentre cohort study

Anaesthesia. 2023 Sep;78(9):1071-1080. doi: 10.1111/anae.16039. Epub 2023 May 24.

Authors

J E O'Carroll¹, L Zucco², E Warwick³, G Arbane², S R Moonesinghe⁴, K El-Boghdadly², N Guo¹, B Carvalho¹, P Sultan¹; ObsQoR Collaborators

Collaborators

ObsQoR Collaborators:
C Abayasinghe, C Abeywardana, L Adams, M Aduse-Poku, M Agarwal, D Ahmed, P Ahuja, H Ali, G Allen, H Aly, H Anderson, P Annamalai, S Appiah, G Arbane, A Arch, S Armstrong, A Ashraf, D Athorn-Wright, R Atkinson, L Austin, B Badal, S Bajaj, M Baker, O Balogun, S Bampoe, D Banni, H Barnes, L Barnes, N Barot, R Barr, R Bassi, L Baxendale, S Beadle, H Beard, F Beatty, S Beeby, J Bell, S Bell, R Benlloch, T Benn, H Bennett, E Beranova, S Berry, H Bethell, K Bhatia, S Bhattacharyya, B Bhattari, R Bhimanaboina, M Bigwood, S Bircham, J Biss, J Bland, O Blightman, P Botchway, L Bouras, J Bowditch, H Boyle, M Bradshaw, L Brady, J Brain, C Brathwaite-Shirley, S Brayshaw, C Bressington, F Brewer, D Bromley, E Brown, J Brown, N Brown, B Brown, D Bruynseels, R Buckley, I Bukowska, S Burnard, R Burnell, R Burnish, C Busby, J Butler, T Camburn, R Campbell, N Campbell, L Canclini, V Cannons, J Cantliffe, A Carey, J Carpenter, J Carpenter, R Carrington, S Carta, R Cassin, G Castle, I Chadderton, K Chadwick, C Challifour, K Cheong, V Cherian-McIvor, R Chirvasuta, T Christmas, A Christopolou, E Clarey, D Cochran, N Coker, A Colhoun, K Colling, E Collins, J Collins, V Collins, G Colville, S Connelly, A Connolly, K Conolloy, C Cooper, S Cope, J Coppel, C Cormack, R Cortaville, D Cottam, S Cotterell, S Cousins, P Coutts, A Cowan, C Craig, C Crail, J Critchley, R Crosby, C Cross, G Crossingham, C Crossland, T Cruz Cervera, O Cummin, S Curtis, S Cusick, A Das, G Davenport, X David, R Davies, J Davies, H Davies, C de la Iglesia, T Dean, J Dearden, K Death, J Deery, C Denford, E Derby, J Desai, C Diaz, M Dissanayake, C Dixon, B Doleman, S Donlon, E Dooks, B Downs, E Duckham, H Dudhill, J Dunning, I Eka, Z Eke, L Elam, A Elfaioumy, R Ellis, C Ellis, A Ellison, C Elton, D Endersby, S Essien, K Evans, J Evans, L Evans, E Finlay, J Finn, R Fishwick, S Fisk, O Flood, V Fludder, M Flynn-Batham, M Flynn-Batham, K Foreman, M Forsey, A Foulds, C Fox, N Freeman, R Fronda, O Froud, L Fulton, M Gaines, F Gallop, L Garden, A Garnder, Z Garner, G Garvey, N Gautam, J Gavin, L Gentle, A Gerth, R Goel, B Gohil, B Goodman, A Gosal, E Gott, S Gowans, C Graham, H Grant, R Greaves, J Greenwood, H Griffiths, J Grindey, Z Grindley, M Guanco, N Guirguis, A Gulati, T Hall, B Hammond, S Hammond, A Hania, A Harish Dave, L Harkett, S Harris, E Hart, J Haslam, R Hawes, F Hayat, S Hazeldine, T Hazelton, R Heard, L Helley, H Hemantha, C Hemeson, S Hendy, S Henry, M Henwood, M Hickson, A Hill, J Hillen, E Hindle, S Hird, G Hobden, R Holcombe-Law, H Hollands, R Holmes, X Holmwood, J Hooper, K House, S Howells, K Hoyland, J Hudsmith, A Hughes, D Hughes, C Hunt, A Hunt, C Huson, C Hussain, T Hussey, R Hyrniv, H Ibrahim, H Iliff, L Imam, H Ingram, H Ingram, E Innes, R Ions, A Isherwood, P Jackson, P Jackson, N Jacques, V Jain, P Jain, R Jama, M Jarvis, J Jennings, H Jennison, R Jesty, B Joakim, J Johal, G John, N John, B Johnston, J Johnston, B Jones, S Jones, K Jones, K Jones, R Jones, E Kalam-Sakit, P Kamath, A Kapoor, A Kaul, L Kavanagh, R Kearns, A Kelkar, N Kennedy, S Kent, J Kenworthy, C Kenyon, T Keown, M Keskar, S Kestner, A Khan, G Khanvelkar, R Khorasanee, S Kimber-Craig, G Kirby, M Klukowski, G Knight, S Knights, A Kostroglou, S Kreppel, A Kumar, N Kurunaratne, K Lake, R Lakhani, B Lalabekyan, B Lally, C Lanaghan, G Landers, T Langcake, M Law, V Laxton, J Le Bas, S Leach, T Lewis, J Lie, S Liggett, H Lindsay, E Lloyd-Davies, V Lowden, R Lucas, B MacAfee, K Maclachlan, B Madhavan, J Major, K Mak, A Malik, H Manteigas, M Maquinana, C Marsh, M Marta, N Martin, G Martir, T Mathew, A Mathews, M Mawathage, M McCague, D McCartney, C McCaul, G McClune, D Mccretton, L McDowell, C McGrath, S McGuirk, A McIlroy, S McLeavey, N McLoughlin, O McNally, H McNamara, E Meadows, A Medniuk, A Melia, Y Metodiev, S Milewczyk, S Miller, A Mills, M Milner, K Miltsios, L Mitchell, M Mittal, A Mohd Azmil, A Moon, C Moore, D Moore, A Morgan, R Mostyn, C Mowat, C Muir, C Mullington, P Nabayego, J Nagari Radhakrishna, P Nalwaya, S Napier, A Nevis, S Ng, A Nicholson, A Nicklin, K Norman, S Nugent, G O'Connor, B O'gara, C Obiozo, R Ochoa-Ferraro, P Odedra, M Ogbomo, D Onwochei, C Ord, L Oshodi, S Pai, R Pallab, P Pankhadiwala, C Papageorgiou, C Papoutsos, J Parker, R Parker, A Parrish, M Patel, K Patel, H Pearson, B Peers, M Penacerrada, S Pepper, G Perkins, S Peroos, K Peshimam, R Phillips, S Phillips, J Pike, J Pike, A Pillai, R Plachikkattle Velu, E Plunkett, M Poole, S Poon, R Powell, L Powell, R Prabhakaran, B Prince, C Prince, Y Prior, J Pullen, S Purvis, R Puttaswamy, A Qaiser, S Quasim, A Quinn, N Qureshi, J Radford, S Rahim, S Rai, A Rand, B Reed, A Rehman, J Retief, A Reyes, J Reynolds, J Reynolds, L Rhodes, K Rhodes, E Rice, M Rich, N Richards, C Rimmer, C Rishton, J Ritzema, L Robbins, S Roberts, B Roberts, E Roberts, K Robins, K Robinson, R Robley, M Roche, J Rochester, N Rodal-Prieto, R Rohit, H Rosser, J Rothwell, L Sach, S Saha, B Saji, K Salmon, V Salota, A Salvana, A Sanderson, L Sanderson, R Sandhar, Z Sarwar, A Sawyerr, R Scale, A Scott, E Searle, H Sellers, S Seraj, R Shankar, S Sharafudeen, I Sharieff, T Sharp, A Sharp, J Shaw, M Shekar, C Shelton, B Shelton, M Sherwin, J Short, A Short, M Simpson, A Singh, V Singler, A Sinha, M Sinnott, S Sivaramakrishnan, E Smee, K Smith, R Smith, R Solly, A Soundararajan, E Sousi, K Spence, P Squires, L Stephenson, J Stewart, K Stoddard, S Stone, M Stubbs, A Sturmey, G Suddick, G Suleymanova, V Sundararajan, S Sundayi, S Supermanian, P Surgey, L Swaminathan, K Swettenham, P Swift, J Syson, P Tamhane, P Tamilselvan, T Tanqueray, E Tanqueray, E Tanton, S Taylor, L Taylor, C Taylor, S Thomas, C Thomas, E Thompson, A Thomson, O Tim, J Tipper, J Towning, C Townsend, M Traves, S Turney, V Turnock, S Twiss, C Uduwela, L Ufton, D Uncles, E Underhill, M Usher, M Vaidya, A Van-Hien, R Varadan, H Venkatesh, P Verma, L Vickers, M Victoria, I Volikas, R Volk, E Waddell, H Waddington, J Wagstaff, J Walker, G Wallace, M Walters, E Walton, A Ware, R Warren, R Watson, E Wells, C Weston, S Wheeler-Davies, S Wheeler-Davies, C Whelan, N White, K Whitehouse, N Wickramasinghe, T Wieder, M Wikner, H Wild, J Wilkinson, D Wilkinson, L Williams, B Williams, C Williams, L Willsher, S Wilson, J Wilson, A Wimalaratne, A Windle, A Wise, D Wixted, J Woollaston, M Woolnough, T Wooten, C Wyatt, P Wyatt, D Wyndham, A Yousef, P Yoxall, M Zawadzka, X Zhao, L Zucco

Affiliations

¹ Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA.
² Department of Anaesthesia and Perioperative Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK.
³ Department of Anaesthesia and Perioperative Medicine, University College London Hospitals, NHS Foundation Trust, London, UK.
⁴ Centre for Peri-operative Medicine, Research Department for Targeted Intervention, Division of Surgery and Interventional Science, University College London, London, UK.

PMID: 37226593
DOI: 10.1111/anae.16039

Abstract

To better understand outcomes in postpartum patients who receive peripartum anaesthetic interventions, we aimed to assess quality of recovery metrics following childbirth in a UK-based multicentre cohort study. This study was performed during a 2-week period in October 2021 to assess in- and outpatient post-delivery recovery at 1 and 30 days postpartum. The following outcomes were reported: obstetric quality of recovery 10-item measure (ObsQoR-10); EuroQoL (EQ-5D-5L) survey; global health visual analogue scale; postpartum pain scores at rest and movement; length of hospital stay; readmission rates; and self-reported complications. In total, 1638 patients were recruited and responses analysed from 1631 (99.6%) and 1282 patients (80%) at one and 30 days postpartum, respectively. Median (IQR [range]) length of stay postpartum was 39.3 (28.5-61.0 [17.7-513.4]), 40.3 (28.5-59.1 [17.8-220.9]), and 35.9 (27.1-54.1 [17.9-188.4]) h following caesarean, instrumental and vaginal deliveries, respectively. Median (IQR [range]) ObsQoR-10 score was 75 ([62-86] 4-100) on day 1, with the lowest ObsQoR-10 scores (worst recovery) reported by patients undergoing caesarean delivery. Of the 1282 patients, complications within the first 30 days postpartum were reported by 252 (19.7%) of all patients. Readmission to hospital within 30 days of discharge occurred in 69 patients (5.4%), with 49 (3%) for maternal reasons. These data can be used to inform patients regarding expected recovery trajectories; facilitate optimal discharge planning; and identify populations that may benefit most from targeted interventions to improve postpartum recovery experience.

Keywords: National Health Service; obstetric anaesthesia; patient reported outcome measures; postpartum; quality of recovery.

Publication types

Multicenter Study

MeSH terms

Cesarean Section* / adverse effects
Cohort Studies
Delivery, Obstetric*
Female
Humans
Postpartum Period
Pregnancy
Prospective Studies

Grants and funding

Obstetric Anaesthetists' Association small grant