Quality of life assessment in pregnant women with the human immunodeficiency virus.
OBJECTIVE
To describe the perceived quality of life and functional status of women with human immunodeficiency virus (HIV) during the antenatal, perinatal, and postpartum periods.


METHODS
Medical Outcome Survey-Short Form questionnaires were completed during antenatal visits, 24 hours after delivery, and 6 months postpartum by 21 HIV-positive women and 21 HIV-negative controls matched for age, race, parity, and education. The Medical Outcome Survey-Short Form measures subject perceptions of overall health, pain, physical role, social and cognitive function, mental health, energy/fatigue, health distress, quality of life, and health transition. Median scores between 0 and 100 (with 0 indicating poorest health) were compared using the Wilcoxon signed-rank and Kruskal Wallis/Dunn tests.


RESULTS
All HIV-positive patients were asymptomatic; the median CD4 count was 386 on entry into the study. Seropositive patients reported increased health distress (50.0 versus 87.5; P < .001) and worse health transition (60.0 versus 80.0; P = .01) during antenatal visits. During the perinatal period, HIV-negative patients had a decreased sense of overall health (40 versus 80; P < .001) and worse health transition (40.0 versus 60.0; P = .04). Six months postpartum, the HIV-positive women reported decreased cognitive function (41.7 versus 62.5; P < .005) and worse social function (33.3 versus 66.7; P = .02). In general, HIV-negative women reported better quality of life in the antepartum as compared with the perinatal or postpartum period. This overall trend was also seen in the HIV-positive population.


CONCLUSIONS
This is the first longitudinal evaluation of perceived quality of life in HIV-positive pregnant subjects. We conclude that perceived quality of life differs between HIV-positive and HIV-negative pregnant women. These differences may not be manifest during initial antenatal visits but may develop as pregnancy, the disease process, and other life events specific to delivery and the postpartum period interact and affect overall perceived quality of life. Longitudinal evaluation of quality-of-life issues may be important in the comprehensive care of HIV-positive women during pregnancy.
Larrabee
K D
KD
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Health Science Center-Houston Medical School, Hermann Hospital, USA.
Monga
M
M
Eriksen
N
N
Helfgott
A
A
D005260:Female; D006679:HIV Seropositivity / Q000150:complications / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D049590:Postpartum Period; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000523:psychology; D011788:Quality of Life; D011795:Surveys and Questionnaires