Application of Repeated Measures Method to Compare Physical Maternal Health Index in a Follow-up Study

Maternal health is a concept indicating the health of mothers during pregnancy, childbirth and the post-partum period. Recent literature indicates that the maternal mortality rate in Iran is 23 per 100,000 live birth. For every death, 20 to 30 mothers suffer from chronic and acute illnesses arising from pregnancy and delivery; therefore, using a valid and reliable indicator will help researchers assess maternal health more precisely. In this longitudinal study, attempt has been made to compare mothers’ health status by using a subjective tool for evaluating the Physical-Maternal Health Index (P-MHI). The most common complaints made by mothers were headache, back pain, mastitis, nipple fissure, breast abscess, abdominal pain, pain in genitalia, constipation, hemorrhoids, anal fissure, urinary problems/Incontinence, fatigue, and dizziness/vertigo. The P-MHI is defined on the basis of these complaints scaling 0-100. The higher the index, the better the health status of mothers. It was administered by structured interviews with 743 participants before and during pregnancy, one week, two, four, and six months after childbirth (2010-2011). Post-natal mothers experience various problems, with back pain and fatigue being the most common. The P-MHI was at its lowest level in the first week after delivery (76 out of 100), followed by the second month (82 out of 100). The results showed that not only do mothers significantly lose their reproductive health after pregnancy, they don't attain their pre-pregnancy health status even six months after delivery (P<0.0005). The trend of the P-MHI identified when and what kind of health care is the most urgent need of post-natal mothers.