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

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

Research output: Contribution to journalArticle

13 Citations (Scopus)

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 healthrelated 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.

LanguageEnglish
Pages1427-1436
Number of pages10
JournalQuality of Life Research
Volume20
Issue number9
DOIs
Publication statusPublished - 1 Jan 2011

Keywords

  • Expectant management
  • Induction of labor
  • Intrauterine growth retardation
  • Quality of life
  • Small for gestational age

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Medicine(all)

Cite this

Bijlenga, Denise ; Boers, Kim E. ; Birnie, Erwin ; Mol, Ben Willem J ; Vijgen, Sylvia C M ; Van Der Post, Joris A M ; De Groot, Christianne J. ; Rijnders, Robbert J P ; Pernet, Paula J. ; Roumen, Frans J. ; Stigter, Rob H. ; Delemarre, Friso M C ; Bremer, Henk A. ; Porath, Martina ; Scherjon, Sicco A. ; Bonsel, Gouke J. / Maternal health-related quality of life after induction of labor or expectant monitoring in pregnancy complicated by intrauterine growth retardation beyond 36 weeks. In: Quality of Life Research. 2011 ; Vol. 20, No. 9. pp. 1427-1436.
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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 healthrelated 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.",
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Bijlenga, D, Boers, KE, Birnie, E, Mol, BWJ, Vijgen, SCM, Van Der Post, JAM, De Groot, CJ, Rijnders, RJP, Pernet, PJ, Roumen, FJ, Stigter, RH, Delemarre, FMC, Bremer, HA, Porath, M, Scherjon, SA & Bonsel, GJ 2011, 'Maternal health-related quality of life after induction of labor or expectant monitoring in pregnancy complicated by intrauterine growth retardation beyond 36 weeks', Quality of Life Research, vol. 20, no. 9, pp. 1427-1436. https://doi.org/10.1007/s11136-011-9891-x

Maternal health-related quality of life after induction of labor or expectant monitoring in pregnancy complicated by intrauterine growth retardation beyond 36 weeks. / Bijlenga, Denise; Boers, Kim E.; Birnie, Erwin; Mol, Ben Willem J; Vijgen, Sylvia C M; Van Der Post, Joris A M; De Groot, Christianne J.; Rijnders, Robbert J P; Pernet, Paula J.; Roumen, Frans J.; Stigter, Rob H.; Delemarre, Friso M C; Bremer, Henk A.; Porath, Martina; Scherjon, Sicco A.; Bonsel, Gouke J.

In: Quality of Life Research, Vol. 20, No. 9, 01.01.2011, p. 1427-1436.

Research output: Contribution to journalArticle

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T1 - Maternal health-related quality of life after induction of labor or expectant monitoring in pregnancy complicated by intrauterine growth retardation beyond 36 weeks

AU - Bijlenga, Denise

AU - Boers, Kim E.

AU - Birnie, Erwin

AU - Mol, Ben Willem J

AU - Vijgen, Sylvia C M

AU - Van Der Post, Joris A M

AU - De Groot, Christianne J.

AU - Rijnders, Robbert J P

AU - Pernet, Paula J.

AU - Roumen, Frans J.

AU - Stigter, Rob H.

AU - Delemarre, Friso M C

AU - Bremer, Henk A.

AU - Porath, Martina

AU - Scherjon, Sicco A.

AU - Bonsel, Gouke J.

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N2 - 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 healthrelated 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.

AB - 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 healthrelated 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.

KW - Expectant management

KW - Induction of labor

KW - Intrauterine growth retardation

KW - Quality of life

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