Jansen A J Gerard, Duvekot Johannes J, Hop Wim C J, Essink-Bot Marie-Louise, Beckers Erik A M, Karsdorp Veronique H M, Scherjon Sicco A, Steegers Eric A P, van Rhenen Dick J
Sanquin Blood Bank South West Region, Rotterdam, The Netherlands.
Acta Obstet Gynecol Scand. 2007;86(5):579-84. doi: 10.1080/00016340701275424.
A delivery has a major impact on the health-related quality of life (HRQoL) of the new mother, especially on fatigue. A common complication during delivery that might have a relationship with maternal morbidity is blood loss. The objectives were to investigate fatigue and HRQoL in women after vaginal delivery (VD), elective caesarean section (CS) and emergency CS, and its relationship with postpartum hemoglobin (Hb) levels during the first 6 weeks postpartum.
Some 141 patients (71 after VD, 36 after elective CS and 34 after emergency CS) completed the HRQoL questionnaires MFI and EQ-5D between 12 and 24 h after VD and 24-48 h after CS (t=0). At 1, 3 and 6 weeks postpartum these questionnaires were repeated, together with the SF36.
Patients after VD had higher mean physical HRQoL scores than after CS. The average period to reach full physical recovery was 3 weeks after VD, 6 weeks after elective CS, and >6 weeks after emergency CS. Mean mental HRQoL scores of the study groups were similar or even better compared to reference values. The significant correlation between Hb level and mean physical HRQoL scores found at t=0 had disappeared at 1 week postpartum.
Results of this study provided insights into the natural course of fatigue and HRQoL postpartum. Important differences in fatigue and HRQoL scores were observed between the 3 modes of delivery. These HRQoL measures can be used in future clinical trials to assess the effects of interventions postpartum.
分娩对新妈妈与健康相关的生活质量（HRQoL）有重大影响，尤其是对疲劳。分娩期间一种可能与产妇发病率相关的常见并发症是失血。本研究的目的是调查经阴道分娩（VD）、择期剖宫产（CS）和急诊剖宫产术后女性的疲劳和HRQoL，及其与产后6周内产后血红蛋白（Hb）水平的关系。
约141例患者（VD术后71例、择期CS术后36例、急诊CS术后34例）在VD术后12至24小时以及CS术后24 - 48小时（t = 0）完成了HRQoL问卷MFI和EQ - 5D。在产后1周、3周和6周重复进行这些问卷调查，同时进行SF36调查。
VD术后患者的平均身体HRQoL得分高于CS术后。达到完全身体恢复的平均时间VD术后为3周，择期CS术后为6周，急诊CS术后超过6周。研究组的平均心理HRQoL得分与参考值相比相似甚至更好。t = 0时发现的Hb水平与平均身体HRQoL得分之间的显著相关性在产后1周消失。
本研究结果为产后疲劳和HRQoL的自然病程提供了见解。在三种分娩方式之间观察到疲劳和HRQoL得分存在重要差异。这些HRQoL测量方法可用于未来的临床试验，以评估产后干预措施的效果。
