The WELSH tool, is valid and sensitive to changes during the assessment of walking ability in severe anemia of pregnancy

The Walking Estimated Limitation Stated by History (WELSH) questionnaire is a pictorial tool for assessing functional walking ability accessible to people with little or no schooling . Its use in severe anemia of pregnancy have not yet been studied. We aimed to evaluate the correlation of the WELSH score to hemoglobin level (Hb) and the sensitivity of the WELSH tool to hemoglobin changes in pregnant women. We performed a prospective study among pregnant women with documented severe biological anemia. Patients completed the WELSH questionnaire upon admission to the hospital and again at the time of discharge after transfusion. We calculated the coefficient of determination between the WELSH and hemoglobin level. The coefficient of determination R² between the Hb and the WELSH score was 0.35 at admission and 0.5 at discharge, the overall R² was 0.83. Area ± SD under the ROC curve (0.980 ± 0.06) for the prediction of a Hb < 7 g/dl from WELSH score was highly significant. The WELSH is sensitive and correlated to changes in Hb in severe anemia of pregnancy. It could help to select women who should be referred to hospital for a hemoglobin determination and potential transfusion, in the context of low-income countries.