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Quality of Life Research
Published in: Quality of Life Research 9/2011

Open Access 01-11-2011

Maternal health-related quality of life after induction of labor or expectant monitoring in pregnancy complicated by intrauterine growth retardation beyond 36 weeks

Authors: Denise Bijlenga, Kim E. Boers, Erwin Birnie, Ben-Willem J. Mol, Sylvia C. M. Vijgen, Joris A. M. Van der Post, Christianne J. De Groot, Robbert J. P. Rijnders, Paula J. Pernet, Frans J. Roumen, Rob H. Stigter, Friso M. C. Delemarre, Henk A. Bremer, Martina Porath, Sicco A. Scherjon, Gouke J. Bonsel

Published in: Quality of Life Research | Issue 9/2011

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Abstract

Objective

Pregnancies complicated by intrauterine growth retardation (IUGR) beyond 36 weeks of gestation are at increased risk of neonatal morbidity and mortality. Optimal treatment in IUGR at term is highly debated. Results from the multicenter DIGITAT (Disproportionate Intrauterine Growth Intervention Trial At Term) trial show that induction of labor and expectant monitoring result in equal neonatal and maternal outcomes for comparable cesarean section rates. We report the maternal health-related quality of life (HR-QoL) that was measured alongside the trial at several points in time.

Methods

Both randomized and non-randomized women were asked to participate in the HR-QoL study. Women were asked to fill out written validated questionnaires, covering background characteristics, condition-specific issues and the Short Form (SF-36), European Quality of Life (EuroQoL 6D3L), Hospital Anxiety and Depression scale (HADS), and Symptom Check List (SCL-90) at baseline, 6 weeks postpartum and 6 months postpartum. We compared the difference scores of all summary measures between the two management strategies by ANOVA. A repeated measures multivariate mixed model was defined to assess the effect of the management strategies on the physical (PCS) and mental (MCS) components of the SF-36. Analysis was by intention to treat.

Results

We analyzed data of 361 randomized and 198 non-randomized patients. There were no clinically relevant differences between the treatments at 6 weeks or 6 months postpartum on any summary measures; e.g., on the SF-36 (PCS: P = .09; MCS: P = .48). The PCS and the MCS were below norm values at inclusion. The PCS improved over time but stayed below norm values at 6 months, while the MCS did not improve.

Conclusion

In pregnancies complicated by IUGR beyond 36 weeks, induction of labor does not affect the long-term maternal quality of life.
Appendix
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Metadata
Title
Maternal health-related quality of life after induction of labor or expectant monitoring in pregnancy complicated by intrauterine growth retardation beyond 36 weeks
Authors
Denise Bijlenga
Kim E. Boers
Erwin Birnie
Ben-Willem J. Mol
Sylvia C. M. Vijgen
Joris A. M. Van der Post
Christianne J. De Groot
Robbert J. P. Rijnders
Paula J. Pernet
Frans J. Roumen
Rob H. Stigter
Friso M. C. Delemarre
Henk A. Bremer
Martina Porath
Sicco A. Scherjon
Gouke J. Bonsel
Publication date
01-11-2011
Publisher
Springer Netherlands
Published in
Quality of Life Research / Issue 9/2011
Print ISSN: 0962-9343
Electronic ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-011-9891-x

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