What is the effect of postpartum hemorrhage on physical activity after cesarean?

Objectives: This study introduces a novel approach, utilizing activity tracking devices (ATDs), such as Fitbit, to monitor mobility during cesarean recovery and investigate the relationship between physical activity (PA) and postpartum hemorrhage (PPH).

Methods: We conducted a prospective cohort study involving postpartum patients aged 18-50 years who delivered at George Washington University and underwent a scheduled or emergent cesarean from December 2022 to September 2023. The primary outcome was assessing the relationship between PPH and PA for 2 weeks postpartum using the Fitbit. Data from all patients were extracted from the electronic medical records. The Fitbit Model of Inspire was used to monitor patients' PA.

Results: Statistical analyses of the relationship between quantitative blood loss (QBL) during cesarean delivery and average steps per day postpartum found statistically non-significant results (Δ1.16 [1.16%], P = 0.817) for the collective cohort. Excluding one outlier from the patient cohort, analysis of the relationship between the same two variables found statistically significant results (Δ1.83 [1.83%], P = 0.023). A coefficient of 1.83 (1.83%) on the QBL variable was found, signifying that an increase of 1 mL in QBL corresponds to an average decrease of 1.83 (1.83%) in average steps per day postpartum.

Conclusion: This study's findings underscore the potential clinical relevance of monitoring PA to identify and address postpartum complications. Further research could explore interventions to mitigate the observed decline in mobility associated with PPH, ultimately enhancing maternal healthcare outcomes.