Multiple pregnancy factors affect postpartum recovery

What the study found: Postpartum recovery is influenced by multiple antenatal and pregnancy-related factors. The review found that previous pain, high body mass index, and antenatal mental health problems were consistently linked with poorer recovery outcomes, while physical activity, social support, and psychological resilience were generally protective.

Why the authors say this matters: The authors conclude that identifying these factors may help improve maternal health, return to work, and social participation. They suggest that a personalized, biopsychosocial approach to care may improve maternal health outcomes and social participation.

What the researchers tested: The researchers conducted a systematic review of studies on antenatal and pregnancy-related factors associated with maternal morbidity beyond 6 weeks postpartum. They searched PubMed, Embase, and Web of Science up to October 2024 and included cohort studies, randomized controlled trials, and cross-sectional studies in women aged 18 years or older who delivered live-born singletons.

What worked and what didn't: The review included 56 studies. Seven categories of influencing factors were identified, including mental health in pregnancy, demographic and socioeconomic background, medical and psychological history, lifestyle in pregnancy, physical health in pregnancy, prepregnancy social and lifestyle factors, and psychosocial resources in pregnancy. Recovery outcomes included persistent pain, mental health problems, functional ability, and urinary incontinence; however, only 9 studies assessed functional ability, and no studies explicitly examined social participation.

What to keep in mind: The review synthesized findings narratively by recovery domain rather than using a single pooled estimate. Limitations are not described in the available summary beyond the narrow outcome focus and the fact that no studies explicitly examined social participation.

Key points

• The review included 56 studies on antenatal and pregnancy-related factors linked to recovery after childbirth.
• Previous pain, high body mass index, and antenatal mental health problems were consistently associated with poorer recovery outcomes.
• Physical activity, social support, and psychological resilience were generally protective factors.
• Only 9 studies assessed functional ability, and no studies explicitly examined social participation.
• The authors suggest a personalized, biopsychosocial approach to care.