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Table 4 Adjusted comparison of quality of life weights and quality-adjusted life days in women with vaginal birth and cesarean section within the first month postpartum

From: Postpartum quality of life in Indian women after vaginal birth and cesarean section: a pilot study using the EQ-5D-5L descriptive system

  QOL weight QALDs (1–21 days postpartum)
Model 1a Model 1b Model 2a Model 2b
Coef. (95% CI) Coef. (95% CI) Coef. (95% CI) Coef. (95% CI)
Vaginal birth (all)    14.6 (12.3, 16.9)m  
 0–3 days postpartum 0.39 (0.27, 0.52)a    
 3–7 days postpartum 0.64 (0.52, 0.76)b    
 21–30 days postpartum 0.76 (0.65, 0.88)c    
Vaginal birth (no episiotomy)     17.1 (14.6, 19.6)n,o
 0–3 days postpartum   0.52 (0.35, 0.7)d,e   
 3–7 days postpartum   0.75 (0.61, 0.89)f,g   
 21–30 days postpartum   0.81 (0.67, 0.95)h,i   
Vaginal birth (episiotomy)     15.3 (131, 17.6)n,p
 0–3 days postpartum   0.41 (0.27, 0.54)d,j   
 3–7 days postpartum   0.66 (0.53, 0.79)f,k   
 21–30 days postpartum   0.81 (0.69, 0.94)h,l   
Cesarean section    11.3 (8.94, 13.7)m 12.5 (10.1, 14.8)o,p
 0–3 days postpartum 0.15 (0.01, 0.29)a 0.2 (0.05, 0.35)e,j   
 3–7 days postpartum 0.46 (0.33, 0.59)b 0.51 (0.37, 0.65)g,k   
 21–30 days postpartum 0.73 (0.62, 0.83)c 0.77 (0.65, 0.89)i,l   
Mother’s age (ref. = 21–24)
 18–20 0.03 (−0.02, 0.08) 0.03 (−0.02, 0.08) 0.49 (−0.49, 1.48) 0.36 (−0.61, 1.33)
 25–30 −0.01 (−0.07, 0.04) −0.02 (−0.07, 0.03) −0.52 (−1.6, 0.56) −0.6 (−1.64, 0.45)
 30–36 0.04 (−0.03, 0.11) 0.03 (−0.04, 0.11) 0.89 (−0.68, 2.45) 0.64 (−0.96, 2.24)
Years of schooling (ref. = secondary: 6–12)
 None 0.06 (0.01, 0.11) 0.06 (0.01, 0.1) 0.33 (−0.66, 1.32) 0.3 (−0.65, 1.25)
 Primary (1–5) 0.06 (0.01, 0.12) 0.06 (0.01, 0.11) 0.756 (−0.332, 1.83) 0.69 (−0.36, 1.75)
 Higher (> 12) −0.13 (−0.23, −0.02) −0.13 (−0.23, −0.02) −2.22 (−4.44, −0.002) −2.18 (−4.53, 0.17)
Caste of woman (ref. = Other Backward Caste)
 Scheduled Caste/Tribe 0.02 (−0.02, 0.06) 0.02 (−0.02, 0.06) −0.17 (−1.06, 0.72) −0.14 (−0.99, 0.71)
 General Caste 0.14 (0.04, 0.23) 0.13 (0.04, 0.22) 1.75 (−0.23, 3.74) 1.64 (−0.27, 3.54)
Household income (ref. = 2500–4999 INR)
 0–2499 INR 0.1 (0.03, 0.18) 0.09 (0.02, 0.17) 1.13 (−0.19, 2.44) 0.85 (−0.37, 2.08)
 5000–9999 INR 0.06 (0.01, 0.12) 0.05 (0.001, 0.11) 0.66 (−0.35, 1.68) 0.48 (−0.52, 1.47)
 10,000–60,000 INR 0.03 (−0.01, 0.08) 0.03 (−0.01, 0.08) 0.08 (−0.92, 1.07) 0.09 (−0.88, 1.07)
Above poverty line 0.04 (−0.01, 0.09) 0.03 (−0.02, 0.08) 0.8 (−0.24, 1.85) 0.6 (−0.42, 1.61)
Previous pregnancies (ref. = 1–2)
 None 0.08 (−0.01, 0.16) 0.04 (−0.05, 0.13) 1.11 (−0.39, 2.61) 0.25 (−1.22, 1.73)
 3–4 0.14 (0.04, 0.25) 0.08 (−0.03, 0.2) 2.05 (0.15, 3.96) 0.49 (−1.51, 2.49)
 5–7 0.05 (−0.08, 0.17) −0.02 (−0.16, 0.12) 1.27 (−1.31, 3.85) −0.42 (−3.06, 2.22)
Risk factors for cesarean section1 −0.003 (−0.06, 0.06) −0.00108 (−0.06, 0.06) 0.36 (−0.85, 1.56) 0.4 (−0.76, 1.56)
Ante- or postpartum hemorrhage −0.03 (−0.12, 0.07) − 0.02 (−0.11, 0.07) −0.69 (−2.39, 1.02) −0.52 (−2.07, 1.02)
Prolonged labor, anemia or fever 0.03 (−0.02, 0.08) 0.03 (−0.02, 0.08) 0.33 (−0.56, 1.22) 0.35 (−0.53,1.23)
Baby is sick (2–3 days postpartum) −0.01 (−0.04, 0.01) −0.02 (−0.05, 0.01) −0.27 (−0.89, 0.34) −0.39 (−1.01, 0.23)
Length of hospital stay (ref. = median duration for birth mode)
  < Median duration for birth mode −0.03 (−0.09, 0.02) −0.03 (−0.08, 0.03) 0.33 (−1.02, 1.69) 0.45 (−0.87, 1.77)
  > Median duration for birth mode −0.04 (−0.11, 0.04) −0.04 (−0.11, 0.03) 0.04 (−1.45, 1.54) −0.06 (−1.47, 1.35)
Health facility (ref. = private hospital)
 Community health center 0.05 (−0.02, 0.11) 0.05 (−0.02, 0.11) 0.29 (−1.24, 1.82) 0.37 (−1.12, 1.87)
 District hospital 0.12 (0.04, 0.21) 0.09 (0.003, 0.18) 1.09 (−0.41, 2.59) 0.24 (−1.33, 1.82)
R2    0.97 0.97
N 224 × 3 224 × 3 224 224
  1. 1Risk factors for cesarean section include premature rupture of membranes, preeclampsia signs, obstructed labor, malpresentation, oligohydramnios, and previous cesarean section
  2. a P < 0.001, b P = < 0.001, c P = 0.30, d P = 0.01, e P < 0.001, f P = 0.008, g P < 0.001, h P = 0.91, i P = 0.28, j P < 0.001, k P = 0.002, l P = 0.20, m P < 0.001, n P < 0.001, o P < 0.001, p P < 0.001. QOL weights increased significantly with the time passed since birth in each of the four birth groups distinguished; P < 0.001 for all comparisons between interview visits
  3. QALDs quality-adjusted life days, QOL quality of life. Models 1 generalized estimating equation of QOL weights, models 2 linear regression of QALDs. Sampling weights were used to resemble a population with an equal number of normal vaginal deliveries and cesarean sections. R2 from linear regression models without intercept