Disability and functioning of women with low‐risk pregnancy: Assessment using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0)

Abstract

Objective To evaluate the disability and functioning of women with low‐risk pregnancy in the second and third gestational trimesters. Methods A longitudinal observational study was conducted from June 5, 2015, to April 30, 2016, in Family Health Units in the city of Santa Cruz, Rio Grande do Norte, Brazil, involving women who were in the second trimester of pregnancy where the pregnancy had been classified as low‐risk. A form was designed specifically for the study to collect sociodemographic, urogynecological, and obstetric data. Functioning and disability were assessed using WHODAS 2.0, and descriptive and inferential statistical analyses were performed. Results Higher levels of disability were observed in cognition in the second trimester (P=0.021), while mobility and life activities domains had higher scores (higher score meaning the woman was more adversely affected) in the third trimester (P=0.007 and P=0.029). Urinary incontinence in the second trimester affected functioning in participation (P=0.023). Pain affected life activities (P=0.023) in the second trimester and participation in the third trimester (P=0.044); and general functioning (P=0.050 and P=0.025), mobility (P=0.002 and P=0.001), and self‐care (P=0.0446 and P=0.023) in the second and third trimesters, respectively. Conclusion The findings showed that, even in a low‐risk pregnancy, functioning can be affected in different domains. The identification of impairments to functioning could enable improvement in care. Longitudinal studies involving the first trimester and postpartum are necessary to gain insight into women's disability and functioning during the pregnancy–puerperal period.

Longitudinal functional status trajectories and its predictors among postpartum women with and without maternal morbidities in Northwest Ethiopia: a group based multi-trajectory modelling

“…Functional status describes a person’s ability to perform a task or activity in the environment in which they live and is the result of a dynamic interaction between health conditions and contextual factors, integrating the different dimensions of health (individual, biological and social) 11 12. Functional status after childbirth is defined as mother’s ability to resume self-care, household, social, community, occupational and infant care activities 13 14…”

Association among dysmenorrhea and activity limitation and participation restrictions in adult women: a cross-sectional study, Brazil -2017

“…Some studies, using WHODAS, of disability in women, have been reported in the following areas: oncology [ 12 – 15 ], obstetrics [ 16 – 18 ], urology [ 19 , 20 ] and sexual function [ 21 ]. These studies underscore the importance of understanding women’s health contexts using the ICF; as well as, understand the impact of women’s health problems on their activities and participation, through a comprehensive and standardized instrument.…”

Trajectories of pain intensity, pain catastrophizing, and pain interference in the perinatal and postpartum period

“…28 Reports of pain interference in pregnancy have been associated with poorer work functioning and difficulty in both physical and daily activities. 6,14 Exploration of pain interference in pregnant samples has been limited; however, previous literature has indicated that pregnant women with higher reports of pain interference are more likely to report greater pain intensity and pain catastrophizing. 10 In the present study, women experiencing higher pain catastrophizing, pain intensity, depressive symptoms, anxiety symptoms, and insomnia were more likely to belong to the moderate or high pain interference trajectory group, as compared to the no pain interference trajectory group.…”

“…Longitudinal studies have been conducted to describe pain experiences during pregnancy and to determine when symptoms are likely to first occur or worsen. 5,14,29 Pain manifests in a broad array of bodily regions, including the truncal regions (lower back, upper back, and pelvic girdle), feet/ankle, knees, hip, wrists/ hands, head, and/or neck. 29,36,45 The constellation of pain, or the type, pattern, and intensity of pain, generally changes for an individual as pregnancy progresses into the postpartum.…”

“…22,36 Pregnancy-related pain has been associated with disruptions to activities of daily living, including but not limited to physical activity, hygiene, and work-related functioning. 6,14 This can lead to feelings of dependence and inadequacy, as well as a loss of personal identity, because unmanaged pain may require women to take premature leave from work, affect their sexual relationship with their partner, and/or make it difficult to engage in selfcare. 6,14 Pain interference, or the extent to which pain affects an individual's activities of daily living, is thus an important consideration in understanding pain experience.…”