In:
PLOS ONE, Public Library of Science (PLoS), Vol. 18, No. 10 ( 2023-10-5), p. e0292393-
Abstract:
Enhanced recovery is the gold standard in modern perioperative management, including that for cesarean deliveries. However, qualitative and quantitative data on the physical and psychological recovery of women after vaginal childbirth are limited. Whether neuraxial labor analgesia influences postpartum recovery is unknown. Methods Primiparous women anticipating a vaginal childbirth between January 2020 and May 2021 were enrolled. Women with major comorbidities or postpartum complications and those who underwent a cesarean delivery were excluded. Daily step count was measured using a wrist-worn activity tracker (Fitbit TM Inspire HR) for 120 hours after vaginal childbirth. Subjective fatigue levels and health-related quality of life were assessed using the Multidimensional Fatigue Inventory (MFI) and EuroQol 5 Dimension 5 Level (EQ-5D-5L), respectively, at the 3 rd trimester antenatal visit, on postpartum day 1 and 3, and at the one-month postpartum visit. Rest and dynamic pain scores and the location of pain were documented by participants during postpartum hospitalization. Results Among 300 women who were enrolled antenatally, 95 and 116 had a vaginal delivery without (NCB group) and with (EPL group) epidural analgesia, respectively. The median number of steps per 24 hours increased daily in both groups, and no significant difference was detected between the groups. Postpartum pain was mild overall, with median rest and dynamic pain scores being less than 4 and similar between the groups. MFI and EQ-5D-5L scores were the worst on postpartum day 1 in both groups and gradually improved to antepartum level by the one-month postpartum visit. Higher MFI score on postpartum day 1, but not the use of epidural analgesia, was associated with lower odds of achieving adequate postpartum ambulation (defined as 〉 3500 steps between 48 and 72 hours postpartum). Conclusion The use of epidural analgesia was not associated with worse recovery outcomes during postpartum hospitalization. Trial registration UMIN-CTR, #UMIN000039343 , registered on January 31, 2020.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0292393
DOI:
10.1371/journal.pone.0292393.g001
DOI:
10.1371/journal.pone.0292393.g002
DOI:
10.1371/journal.pone.0292393.g003
DOI:
10.1371/journal.pone.0292393.g004
DOI:
10.1371/journal.pone.0292393.t001
DOI:
10.1371/journal.pone.0292393.t002
DOI:
10.1371/journal.pone.0292393.s001
DOI:
10.1371/journal.pone.0292393.s002
DOI:
10.1371/journal.pone.0292393.s003
DOI:
10.1371/journal.pone.0292393.s004
DOI:
10.1371/journal.pone.0292393.s005
DOI:
10.1371/journal.pone.0292393.s006
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2267670-3
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