Poor Health-related Quality of Life After Severe Preeclampsia

Authors

  • Meeke Hoedjes MSc,

    1. Meeke Hoedjes is a Doctoral Student in the Department of Public Health; Durk Berks is a Trainee Gynecologist and Doctoral Student in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Ineke Vogel is a Researcher in the Department of Public Health; Johannes J. Duvekot is a Perinatologist in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Eric A.P. Steegers is a Professor in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Hein Raat is an Associate Professor in the Department of Public Health, Erasmus University Medical Center, Rotterdam; and Arie Franx is a Maternal Fetal Medicine Specialist in the Department of Obstetrics, University Medical Center, Utrecht, The Netherlands.
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  • Durk Berks MD,

    1. Meeke Hoedjes is a Doctoral Student in the Department of Public Health; Durk Berks is a Trainee Gynecologist and Doctoral Student in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Ineke Vogel is a Researcher in the Department of Public Health; Johannes J. Duvekot is a Perinatologist in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Eric A.P. Steegers is a Professor in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Hein Raat is an Associate Professor in the Department of Public Health, Erasmus University Medical Center, Rotterdam; and Arie Franx is a Maternal Fetal Medicine Specialist in the Department of Obstetrics, University Medical Center, Utrecht, The Netherlands.
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  • Ineke Vogel PhD,

    1. Meeke Hoedjes is a Doctoral Student in the Department of Public Health; Durk Berks is a Trainee Gynecologist and Doctoral Student in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Ineke Vogel is a Researcher in the Department of Public Health; Johannes J. Duvekot is a Perinatologist in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Eric A.P. Steegers is a Professor in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Hein Raat is an Associate Professor in the Department of Public Health, Erasmus University Medical Center, Rotterdam; and Arie Franx is a Maternal Fetal Medicine Specialist in the Department of Obstetrics, University Medical Center, Utrecht, The Netherlands.
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  • Arie Franx MD, PhD,

    1. Meeke Hoedjes is a Doctoral Student in the Department of Public Health; Durk Berks is a Trainee Gynecologist and Doctoral Student in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Ineke Vogel is a Researcher in the Department of Public Health; Johannes J. Duvekot is a Perinatologist in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Eric A.P. Steegers is a Professor in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Hein Raat is an Associate Professor in the Department of Public Health, Erasmus University Medical Center, Rotterdam; and Arie Franx is a Maternal Fetal Medicine Specialist in the Department of Obstetrics, University Medical Center, Utrecht, The Netherlands.
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  • Johannes J. Duvekot MD, PhD,

    1. Meeke Hoedjes is a Doctoral Student in the Department of Public Health; Durk Berks is a Trainee Gynecologist and Doctoral Student in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Ineke Vogel is a Researcher in the Department of Public Health; Johannes J. Duvekot is a Perinatologist in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Eric A.P. Steegers is a Professor in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Hein Raat is an Associate Professor in the Department of Public Health, Erasmus University Medical Center, Rotterdam; and Arie Franx is a Maternal Fetal Medicine Specialist in the Department of Obstetrics, University Medical Center, Utrecht, The Netherlands.
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  • Eric A. P. Steegers MD, PhD,

    1. Meeke Hoedjes is a Doctoral Student in the Department of Public Health; Durk Berks is a Trainee Gynecologist and Doctoral Student in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Ineke Vogel is a Researcher in the Department of Public Health; Johannes J. Duvekot is a Perinatologist in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Eric A.P. Steegers is a Professor in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Hein Raat is an Associate Professor in the Department of Public Health, Erasmus University Medical Center, Rotterdam; and Arie Franx is a Maternal Fetal Medicine Specialist in the Department of Obstetrics, University Medical Center, Utrecht, The Netherlands.
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  • Hein Raat MD, PhD

    1. Meeke Hoedjes is a Doctoral Student in the Department of Public Health; Durk Berks is a Trainee Gynecologist and Doctoral Student in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Ineke Vogel is a Researcher in the Department of Public Health; Johannes J. Duvekot is a Perinatologist in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Eric A.P. Steegers is a Professor in the Department of Obstetrics and Gynecology, Division of Obstetrics and Prenatal Medicine; Hein Raat is an Associate Professor in the Department of Public Health, Erasmus University Medical Center, Rotterdam; and Arie Franx is a Maternal Fetal Medicine Specialist in the Department of Obstetrics, University Medical Center, Utrecht, The Netherlands.
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  • This study was funded by The Netherlands Organization for Health Research and Development, The Hague, The Netherlands (ZonMw Grant No. 6120.0024).

Address correspondence to Meeke Hoedjes, MSc, Department of Public Health, Erasmus University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.

Abstract

Abstract:  Background:  Preeclampsia is a major complication of pregnancy associated with increased maternal morbidity and mortality, and adverse birth outcomes. The objective of this study was to describe changes in all domains of health-related quality of life between 6 and 12 weeks postpartum after mild and severe preeclampsia; to assess the extent to which it differs after mild and severe preeclampsia; and to assess which factors contribute to such differences.

Methods:  We conducted a prospective multicenter cohort study of 174 postpartum women who experienced preeclampsia, and who gave birth between February 2007 and June 2009. Health-related quality of life was measured at 6 and 12 weeks postpartum by the RAND 36-item Short-Form Health Survey (SF-36). The population for analysis comprised women (74%) who obtained scores on the questionnaire at both time points.

Results:  Women who experienced severe preeclampsia had a lower postpartum health-related quality of life than those who had mild preeclampsia (all p < 0.05 at 6 wk postpartum). Quality of life improved on almost all SF-36 scales from 6 to 12 weeks postpartum (p < 0.05). Compared with women who had mild preeclampsia, those who experienced severe preeclampsia had a poorer mental quality of life at 12 weeks postpartum (p < 0.05). Neonatal intensive care unit admission and perinatal death were contributing factors to this poorer mental quality of life.

Conclusions:  Obstetric caregivers should be aware of poor health-related quality of life, particularly mental health quality of life in women who have experienced severe preeclampsia (especially those confronted with perinatal death or their child’s admission to a neonatal intensive care unit), and should consider referral for postpartum psychological care. (BIRTH 38:3 September 2011)

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