Babette W Prick1, Denise Bijlenga2, A J Gerard Jansen3, Kim E Boers4, Sicco A Scherjon5, Corine M Koopmans5, Marielle G van Pampus6, Marie-Louise Essink-Bot2, Dick J van Rhenen3, Ben W Mol7, Johannes J Duvekot8. 1. Department of Obstetrics and Gynecology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Obstetrics and Gynecology, Maasstad Hospital, Rotterdam, The Netherlands. 2. Department of Public Health, Academic Medical Centre, Amsterdam, The Netherlands. 3. Sanquin Blood Supply Foundation, Rotterdam, The Netherlands. 4. Department of Obstetrics and Gynecology, Bronovo Hospital, Den Haag, The Netherlands. 5. Department of Obstetrics and Gynecology, University Medical Centre Groningen, Groningen, The Netherlands. 6. Department of Obstetrics and Gynecology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. 7. School of Pediatrics and Reproductive Health, University of Adelaide, Adelaide 5000 SA, Australia. 8. Department of Obstetrics and Gynecology, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: j.j.duvekot@erasmusmc.nl.
Abstract
OBJECTIVE: To determine the influence of socio-demographic, clinical parameters and obstetric complications on postpartum health-related quality of life (HRQoL). STUDY DESIGN: We used data of three randomized controlled trials to investigate HRQoL determinants in women after an obstetric complication. The DIGITAT and HYPITAT trials compared induction of labor and expectant management in women with intra-uterine growth restriction (IUGR) and hypertensive disorders. The WOMB trial randomized anemic women after postpartum hemorrhage to red blood cell transfusion or expectant management. The HRQoL-measure Short-Form36 was completed at six weeks postpartum. Multivariable analyses were used to identify which parameters affected the Short-Form36 physical component score (PCS) and mental component score (MCS). RESULTS: HRQoL analyses included 1391 women (60%) of the 2310 trial participants. HYPITAT and DIGITAT participants had significantly lower MCS than WOMB participants. In multivariable analysis, PCS after elective and emergency cesarean section was 5-6 points lower than after vaginal delivery. Gestational hypertension, neonatal admission and delivery in an academic hospital had a small negative effect on PCS. No effect was found for randomization status, maternal age, BMI, country of birth, education, parity, induction of labor, analgesics, birth weight, perineal laceration, delivery of placenta, postpartum hemorrhage, congenital anomaly, urinary tract infection, thromboembolic event or endometritis. MCS was influenced only mildly by these parameters. CONCLUSIONS: IUGR and hypertensive disorders lead to lower HRQoL scores postpartum than PPH. In a heterogeneous obstetric population, only mode of delivery by cesarean section has a profound, negative impact, on physical HRQoL (PCS). No profound impacts on MCS were detected.
RCT Entities:
OBJECTIVE: To determine the influence of socio-demographic, clinical parameters and obstetric complications on postpartum health-related quality of life (HRQoL). STUDY DESIGN: We used data of three randomized controlled trials to investigate HRQoL determinants in women after an obstetric complication. The DIGITAT and HYPITAT trials compared induction of labor and expectant management in women with intra-uterine growth restriction (IUGR) and hypertensive disorders. The WOMB trial randomized anemicwomen after postpartum hemorrhage to red blood cell transfusion or expectant management. The HRQoL-measure Short-Form36 was completed at six weeks postpartum. Multivariable analyses were used to identify which parameters affected the Short-Form36 physical component score (PCS) and mental component score (MCS). RESULTS: HRQoL analyses included 1391 women (60%) of the 2310 trial participants. HYPITAT and DIGITATparticipants had significantly lower MCS than WOMB participants. In multivariable analysis, PCS after elective and emergency cesarean section was 5-6 points lower than after vaginal delivery. Gestational hypertension, neonatal admission and delivery in an academic hospital had a small negative effect on PCS. No effect was found for randomization status, maternal age, BMI, country of birth, education, parity, induction of labor, analgesics, birth weight, perineal laceration, delivery of placenta, postpartum hemorrhage, congenital anomaly, urinary tract infection, thromboembolic event or endometritis. MCS was influenced only mildly by these parameters. CONCLUSIONS: IUGR and hypertensive disorders lead to lower HRQoL scores postpartum than PPH. In a heterogeneous obstetric population, only mode of delivery by cesarean section has a profound, negative impact, on physical HRQoL (PCS). No profound impacts on MCS were detected.
Authors: Sarah Aissi James; Thomas Klein; Guillaume Lebreton; Jacky Nizard; Juliette Chommeloux; Nicolas Bréchot; Marc Pineton de Chambrun; Guillaume Hékimian; Charles-Edouard Luyt; Bruno Levy; Antoine Kimmoun; Alain Combes; Matthieu Schmidt Journal: Crit Care Date: 2022-04-07 Impact factor: 9.097
Authors: Carina R Angelini; Rodolfo C Pacagnella; Mary A Parpinelli; Carla Silveira; Carla B Andreucci; Elton C Ferreira; Juliana P Santos; Dulce M Zanardi; Renato T Souza; Maria H Sousa; Jose G Cecatti Journal: Biomed Res Int Date: 2018-07-17 Impact factor: 3.411