Department of Public Health, Erasmus University Medical Center, Rotterdam.
Birth. 2011 Sep;38(3):246-55. doi: 10.1111/j.1523-536X.2011.00477.x. Epub 2011 May 20.
Preeclampsia is a major complication of pregnancy associated with increased maternal morbidity and mortality, and adverse birth outcomes. The objective of this study was to describe changes in all domains of health-related quality of life between 6 and 12 weeks postpartum after mild and severe preeclampsia; to assess the extent to which it differs after mild and severe preeclampsia; and to assess which factors contribute to such differences.
We conducted a prospective multicenter cohort study of 174 postpartum women who experienced preeclampsia, and who gave birth between February 2007 and June 2009. Health-related quality of life was measured at 6 and 12 weeks postpartum by the RAND 36-item Short-Form Health Survey (SF-36). The population for analysis comprised women (74%) who obtained scores on the questionnaire at both time points.
Women who experienced severe preeclampsia had a lower postpartum health-related quality of life than those who had mild preeclampsia (all p < 0.05 at 6 wk postpartum). Quality of life improved on almost all SF-36 scales from 6 to 12 weeks postpartum (p < 0.05). Compared with women who had mild preeclampsia, those who experienced severe preeclampsia had a poorer mental quality of life at 12 weeks postpartum (p < 0.05). Neonatal intensive care unit admission and perinatal death were contributing factors to this poorer mental quality of life.
Obstetric caregivers should be aware of poor health-related quality of life, particularly mental health quality of life in women who have experienced severe preeclampsia (especially those confronted with perinatal death or their child's admission to a neonatal intensive care unit), and should consider referral for postpartum psychological care.
子痫前期是一种与产妇发病率和死亡率增加以及不良母婴结局相关的主要妊娠并发症。本研究的目的是描述轻度和重度子痫前期产后 6-12 周时健康相关生活质量各领域的变化；评估轻度和重度子痫前期后差异的程度；并评估哪些因素导致了这种差异。
我们进行了一项前瞻性多中心队列研究，纳入了 174 名经历过子痫前期并于 2007 年 2 月至 2009 年 6 月间分娩的产后妇女。采用 RAND 36 项短式健康调查问卷（SF-36）在产后 6 和 12 周时测量健康相关生活质量。分析人群包括在两个时间点都获得问卷评分的女性（74%）。
重度子痫前期患者产后健康相关生活质量低于轻度子痫前期患者（所有 p<0.05，产后 6 周时）。从产后 6 周到 12 周，SF-36 量表上的生活质量几乎在所有方面都有所改善（p<0.05）。与轻度子痫前期患者相比，重度子痫前期患者在产后 12 周时的心理健康质量较差（p<0.05）。新生儿重症监护病房的入院和围产儿死亡是导致这种较差的心理健康质量的因素。
产科护理人员应意识到经历重度子痫前期的女性生活质量较差，特别是心理健康质量较差（尤其是那些面临围产儿死亡或其孩子入住新生儿重症监护病房的女性），并应考虑转介产后心理护理。
