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Type: Journal article
Title: Health-related quality of life after induction of labor versus expectant monitoring in gestational hypertension or preeclampsia at term
Author: Bijlenga, D.
Koopmans, C.
Birnie, E.
Mol, B.
van der Post, J.
Bloemenkamp, K.
Scheepers, L.
Willekes, C.
Kwee, A.
Heres, M.
van Beek, E.
van Meir, C.
van Huizen, M.
van Pampus, M.
Bonsel, G.
Citation: Hypertension in Pregnancy, 2011; 30(3):260-274
Publisher: Marcel Dekker Inc
Issue Date: 2011
ISSN: 1064-1955
Abstract: <h4>Objective</h4>Gestational hypertension (GH) and preeclampsia (PE) are major contributors to maternal and neonatal morbidity and mortality. In GH or PE, labor may be either induced or monitored expectantly. We studied maternal health-related quality of life (HR-QoL) after induction of labor versus expectant monitoring in GH or PE at term. We performed the HR-QoL study alongside a multicenter randomized controlled trial comparing induction of labor to expectant monitoring in women with GH or PE after 36 weeks.<h4>Methods</h4>We used written questionnaires, covering background characteristics, condition-specific issues, and validated measures: the Short-Form (SF-36), European Quality of Life (EuroQoL 6D3L), Hospital Anxiety and Depression Scale (HADS), and Symptom Checklist (SCL-90). Measurements were at the following time points: baseline, 6 weeks postpartum, and 6 months postpartum. A multivariate mixed model with repeated measures was defined to assess the effect of the treatments on the physical component score (PCS) and mental component score (MCS) of the SF-36. Analysis was by intention to treat.<h4>Results</h4>We analyzed the data of 491 randomized and 220 nonrandomized women. We did not find treatment effect on long-term HR-QoL (PCS: p = 0.09; MCS: p = 0.82). The PCS improved over time (p < 0.001) and was better in nonrandomized patients (p = 0.02).<h4>Conclusion</h4>Despite a clinical benefit of induction of labor, long-term HR-QoL is equal after the induction of labor and expectant management in women with GH or PE beyond 36 weeks of gestation.
Keywords: Humans; Hypertension, Pregnancy-Induced; Pre-Eclampsia; Fetal Monitoring; Treatment Outcome; Labor, Induced; Health Status; Pregnancy; Quality of Life; Adult; Female
RMID: 0020136788
DOI: 10.3109/10641955.2010.486458
Appears in Collections:Obstetrics and Gynaecology publications

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