General health and psychological symptom status in pregnancy and the puerperium: What is normal?

Objective: To identify normative changes in psychological and physiologic h ealth status associated with pregnancy and the puerperium. Methods: Self-administered surveys containing Ware's Short Form-36 and Dero gatis's Brief Symptom Inventory were completed by 393 pregnant women during their third trimester. Of those, 253 completed the same survey during the puerperium. Results were compared between periods and with those of samples of women from standardized community samples. Results: On the Short Form-36, pregnant women in the third trimester had si gnificantly poorer levels of functioning (P < .01) than community controls with regard to bodily pain (51.86 versus 79.61), physical functioning (62.9 1 versus 89.12), social functioning (74.0 versus 84.06), vitality (47.24 ve rsus 58.04), and functional limitations resulting from physical health prob lems (45.0 versus 86.73) subscales. Those differences persisted into the pu erperium. Compared with pregnancy, scores on social functioning and functio nal limitations caused by emotional problems decreased during the puerperiu m. Women reported improved perceptions of their general health in the puerp erium compared with community controls (80.22 versus 74.80). On the Brief S ymptom Inventory, pregnant women reported significantly higher levels of em otional distress on the three global measures and on the somatization (0.75 versus 0.35), obsessive-compulsive (0.70 versus 0.48), and hostility (0.59 versus 0.36) subscales than controls; those changes normalized in the puer perium. Conclusion: Pregnancy and the puerperium are associated with significant ch anges in psychological and physiologic health status. Documentation of thos e changes is important if the Short Form-36 and Brief Symptom Inventory are to be used in health outcomes research with this population. (Obstet Gynec ol 1999;94:935-41. (C) 1999 by The American College of Obstetricians and Gy necologists.).