Psychometric validation of the Obstetric Quality of Recovery-10 scoring tool across the first month postpartum: a cross-sectional psychometric study

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Abstract

Background

Postpartum recovery is a public health concern. The Obstetric Quality of Recovery-10 (ObsQoR-10) is a brief patient-reported outcome measure designed to assess early recovery after childbirth. Its validation is currently limited to the first three days postpartum. This study aimed to evaluate the psychometric properties of the ObsQoR-10 across the first 30 days postpartum.

Methods

We conducted a cross-sectional psychometric evaluation of the ObsQoR-10 using baseline data from a national Swiss multilingual cohort (French, German, Italian, and English). Women were recruited within the first week postpartum and completed the ObsQoR-10 and the EuroQol 5-Dimensions 5-Levels (EQ-5D-5L) at a single time point within 30 days postpartum. Clinical data were extracted from medical records. Analyses were performed across three postpartum windows (0–2, 3–7, and 8–30 days). Structural validity, measurement invariance, reliability, and construct validity (convergent and known-groups) were assessed.

Results

A total of 1,935 women were included. Structural validity supported a stable four-factor structure with excellent model fit (CFI 0.995–0.997; RMSEA 0.055–0.059), and bifactor analysis supported essential unidimensionality. Measurement invariance was confirmed at metric and scalar levels across postpartum windows. Reliability was good (Cronbach’s alpha 0.83–0.86). Convergent validity was supported by moderate correlations with the EQ-5D-5L (ρ = −0.51 to −0.30), decreasing over time. Known-groups validity was demonstrated by significantly lower scores in women with poorer health status, postpartum haemorrhage, and operative or caesarean birth (all p <0.001).

Conclusions

The ObsQoR-10 demonstrates consistent, valid, and reliable psychometric properties for assessing postpartum recovery across the first 30 days.

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