Bijlenga Denise, Koopmans Corine M, Birnie Erwin, Mol Ben-Willem J, van der Post Joris A, Bloemenkamp Kitty W, Scheepers Hubertina C, Willekes Christine, Kwee Anneke, Heres Marion H, Van Beek Erik, Van Meir Claudia A, Van Huizen Marloes E, Van Pampus Maria G, Bonsel Gouke J
Department of Public Health, Academic Medical Centre, Amsterdam, The Netherlands.
Hypertens Pregnancy. 2011;30(3):260-74. doi: 10.3109/10641955.2010.486458.
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.
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.
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).
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.
妊娠期高血压（GH）和子痫前期（PE）是导致孕产妇和新生儿发病及死亡的主要因素。对于GH或PE患者，可选择引产或期待监测。我们研究了足月GH或PE患者引产与期待监测后的孕产妇健康相关生活质量（HR-QoL）。我们在一项多中心随机对照试验中进行了HR-QoL研究，该试验比较了孕36周后GH或PE患者引产与期待监测的效果。
我们使用了书面问卷，涵盖背景特征、特定病情问题以及经过验证的测量工具：简短健康调查问卷（SF-36）、欧洲生活质量量表（EuroQoL 6D3L）、医院焦虑抑郁量表（HADS）和症状自评量表（SCL-90）。测量时间点为：基线、产后6周和产后6个月。定义了一个带有重复测量的多变量混合模型，以评估治疗对SF-36身体成分评分（PCS）和心理成分评分（MCS）的影响。分析采用意向性治疗。
我们分析了491名随机分组和220名非随机分组女性的数据。我们未发现治疗对长期HR-QoL有影响（PCS：p = 0.09；MCS：p = 0.82）。PCS随时间改善（p < 0.001），且在非随机患者中更好（p = 0.02）。
尽管引产有临床益处，但对于孕周超过36周的GH或PE女性，引产和期待管理后的长期HR-QoL相当。
