Poor health-related quality of life after severe preeclampsia

BACKGROUND: 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.

METHODS: 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.

RESULTS:   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.

CONCLUSIONS: 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.