Construct validation of a complete postpartum health and well-being patient reported outcome measure: prospective cohort study.

Background: Despite a focus on patient-reported outcome measures (PROM) in maternity care, a standardized tool is lacking. Current existing measures often focus on a single dimension of postpartum health. Objective: This study evaluated the construct validity of using a suite of PROMs based on the top psychometrically validated tools available. They were combined to achieve coverage of all important aspects of postpartum well-being outlined by the International Consortium of Health Outcomes (ICHOM). Methods: Recruitment took place in a tertiary university maternity hospital between April 3 Results: 534 women were recruited, with an average age of 32 years (±5.0), 90.6% (n=484) had term deliveries, 59% (n=316) were multiparous, 40% (n=216) had spontaneous vaginal deliveries (SVD), 12% (n=63) had operative vaginal deliveries and 47.7% (n= 255) had caesarean sections. Examining the tools' ability to detect changes based on morbidity found no significant differences in PQoL, ICIQ-UI SF or pelvic pain scores between groups with and without maternal morbidity. There were also no differences found in the scores of mothers who had babies admitted to the Neonatal Unit (NNU). Examining score differences based on delivery type, found no variations in total PQoL scores across all timepoints. There were no score differences at other time points in the ICIQ-UI SF or pelvic pain question scores. The PQoL, ICIQ-UI SF and the pelvic pain with sexual intercourse questions had statistically significant difference in their overall scores over the 3 timepoints of the study. The PQoL scores were T1: 128 [ Conclusion: While this suite of PROMs demonstrated sensitivity in detecting changes in postpartum well-being over time, it did not consistently discern differences based on morbidity (maternal or neonatal) or on delivery type. These findings suggest the need for a more clinically relevant postpartum PROM.