A Multicentre Assessment of Factors Associated With Worse Postpartum Recovery Using the STanford Obstetric Recovery checKlist (STORK).

Abstract

Objective: The STanford Obstetric Recovery checKlist (STORK) is a validated patient-reported outcome measure that assesses outpatient postpartum recovery across four domains. We aimed to identify factors associated with worse global recovery at 6 weeks postpartum, and across individual domains at 2 and 12 weeks using STORK.

Methods: In this secondary analysis of the STORK validation study, English-speaking adults at three US academic centers completed STORK within 24±12 hours of delivery and at 2, 6 and 12 weeks postpartum. The primary outcome was worse global recovery at 6 weeks, defined as STORK scores in the lowest quartile. Secondary outcomes were worse individual domains at 6 weeks, and worse global recovery at 2 and 12 weeks. Variables with P < 0.2 in univariate analyses were entered into multivariable logistic regression models.

Results: Among 498 participants (mean age 33±5 years), American Society of Anesthesiologists class 3 (P = 0.006) and low inpatient STORK scores (P = 0.001) were independently associated with worse global recovery at 6 weeks. Low inpatient psychosocial domain scores were associated with worse physical (P = 0.001) and psychosocial recovery (P < 0.001), and low inpatient sleep and fatigue scores with worse sleep and fatigue (P = 0.03) at 6 weeks. Low inpatient global STORK scores were also associated with worse global scores at 2 and 12 weeks (P < 0.001).

Conclusion: Poor inpatient recovery, particularly within psychosocial domains, is associated with worse outpatient recovery at 6 weeks. Inpatient STORK assessment may help identify patients at risk of worse recovery, though whether acting on scores improves recovery requires further study.