What delivery-related factors affect postpartum recovery? A systematic review
Bibliographic record
Abstract
OBJECTIVE: This study aimed to identify the delivery-related factors that affect postpartum recovery. DATA SOURCES: The PubMed, Embase, and Web of Science databases were searched until April 2024 using the following terms: "Childbirth," "Caesarean section," "Complications," "Recovery," and "Time Factors." Studies in English or Dutch were considered for inclusion. STUDY ELIGIBILITY CRITERIA: All studies that included participants aged ≥18 years who delivered a live-born singleton and that evaluated the effect of delivery-related factors on recovery of health, ability, and activity in the postpartum period with a minimum follow-up period of 6 weeks were included. METHODS: Data from the included studies were extracted, and quality assessment was performed using the Newcastle-Ottawa Scale. RESULTS: A total of 38 articles were included. Of note, 5 different factors related to delivery that could affect recovery were identified as follows: mode of delivery, perineal lacerations, birth experience, parity, and neonatal factors. Articles could evaluate multiple affecting factors. Outcome measures were related to (genitopelvic or surgical site) pain, incontinence, mental health, and functional ability. Of note, 8 articles reported a negative effect on at least one of the outcome measures after cesarean delivery, 4 articles reported no significant difference between the delivery modes, and 2 articles found a negative effect on one of the outcome measures after vaginal delivery compared with cesarean delivery. Most articles (14/17) on perineal trauma reported a negative effect on recovery regarding incontinence and perineal pain. A negative birth experience was significantly associated with postpartum depression up to 6 weeks after childbirth. Parity of >2 was associated with more dyspareunia, and a high neonatal birthweight was associated with more pelvic pain. CONCLUSION: Our study findings indicate that mode of delivery, particularly cesarean delivery, is most frequently reported as having an effect on postpartum recovery. Recovery took longer (and was more painful) after cesarean delivery than after vaginal delivery. Extensive (third- and fourth-degree) perineal lacerations are frequently reported as an affecting factor. A small number of articles used functional ability as an outcome measure and attention for social participation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.051 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.008 |
| Bibliometrics | 0.011 | 0.012 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".