Authors: Antonio Gonzalez Fiol, Geoffrey Ho, Dongchen Li, Richard Amdur, PhD4, Chapman Wei, Homa K. Ahmadzia, Marianne David, Christopher Jackson, Jeffrey S Berger.
Background: Early mobility is one of the main goals of the enhanced recovery after cesarean delivery, yet it is rarely objectively measured. Benefits related to this goal include mechanical prevention of deep venous thrombosis and early discharge.
Methods: We conducted a multi-center prospective study in which an activity tracker was utilized to measure the steps taken by patients after delivery. The primary outcome was steps taken after vaginal or cesarean delivery. Secondary outcomes was factors affecting ambulation (e.g pain/satisfaction with pain management and mode of delivery).
Results: Data from 50 postpartum patients were analyzed. Vaginal delivery patients took more cumulative steps at all times when compared to cesarean delivery patients. At 24 and 48 h vaginal and cesarean delivery patients took 5911 ± 2162 versus 3421± 2314 (P = 0.0006) and 9813 ± 3916 versus 6306 ± 5835 (P = 0.03), respectively. In the random effects mixed model, mode of delivery and time main effect were also significant (p<0.0001). In addition, each point increase in body mass index was noted to decrease the number of steps by 35 (95% CI -68 to -3).
Conclusion: Ambulation in the first 48 h after delivery is mainly affected by the mode of delivery and body mass index.