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While clinical complications are assessed, postpartum functional outcomes are not well understood from a patient\u2019s perspective or well-characterized by previous studies. In Rwanda, 11% of rural women deliver via c-section. This study explores the functional recovery of rural Rwandan women after c-section and assesses factors that predict poor functionality at postoperative day (POD) 30.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected prospectively on POD 3, 11, and 30 from women delivering at Kirehe District Hospital between October 2019 and March 2020. Functionality was measured by self-reported overall health, energy level, mobility, self-care ability, and ability to perform usual activities; and each domain was rated on a 4-point likert scale, lower scores reflecting higher level of difficulties. Using the four functionality domains, we computed composite mean scores with a maximum score of 4.0 and we defined poor functionality as composite score of\u2009\u2264\u20092.0. We assessed functionality with descriptive statistics and logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 617 patients, 54.0%, 25.9%, and 26.8% reported poor functional status at POD3, POD11, and POD30, respectively. At POD30, the most self-reported poor functionality dimensions were poor or very poor overall health (48.1%), and inability to perform usual activities (15.6%). In the adjusted model, women whose surgery lasted 30\u201345\u00a0min had higher odds of poor functionality (aOR\u2009=\u20091.85,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), as did women who experienced intraoperative complications (aOR\u2009=\u20094.12, 95% CI (1.09, 25.57),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.037). High income patients had incrementally lower significant odds of poor physical functionality (aOR\u2009=\u20090.62 for every US$1 increase in monthly income, 95% CI (0.40, 0.96)\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We found a high proportion of poor physical functionality 30\u00a0days post-c-section in this Rwandan cohort. Surgery lasting\u2009&gt;\u200930\u00a0min and intra-operative complications were associated with poor functionality, whereas a reported higher income status was associated with lower odds of poor functionality. Functional status assessments, monitoring and support should be included in post-partum care for women who delivered via c-section. Effective risk mitigating intervention should be implemented to recover functionality after c-section, particularly among low-income women and those undergoing longer surgical procedures or those with intraoperative complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12884-023-06159-3","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T22:02:19Z","timestamp":1702418539000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Functional recovery after cesarean delivery: a prospective cohort study in rural Rwanda"],"prefix":"10.1186","volume":"23","author":[{"given":"Anne","family":"Niyigena","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saidath","family":"Gato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barnabas","family":"Alayande","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Miranda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany","family":"Hedt-Gauthier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea S.","family":"Goodman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theoneste","family":"Nkurunziza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Mazimpaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadoscar","family":"Hakizimana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patient","family":"Ngamije","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fredrick","family":"Kateera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Riviello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adeline A.","family":"Boatin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,12,13]]},"reference":[{"key":"6159_CR1","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1186\/s12913-019-3920-9","volume":"19","author":"K Albutt","year":"2019","unstructured":"Albutt K, Punchak M, Kayima P, Namanya DB, Shrime MG. 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