title: New insights into fatigue and health-related quality of life after delivery.
abstract: BACKGROUND
  A delivery has a major impact on the health-related quality of life (HRQoL) of the new mother, especially on fatigue. A common complication during delivery that might have a relationship with maternal morbidity is blood loss. The objectives were to investigate fatigue and HRQoL in women after vaginal delivery (VD), elective caesarean section (CS) and emergency CS, and its relationship with postpartum hemoglobin (Hb) levels during the first 6 weeks postpartum.
  
  
  METHODS
  Some 141 patients (71 after VD, 36 after elective CS and 34 after emergency CS) completed the HRQoL questionnaires MFI and EQ-5D between 12 and 24 h after VD and 24-48 h after CS (t=0). At 1, 3 and 6 weeks postpartum these questionnaires were repeated, together with the SF36.
  
  
  RESULTS
  Patients after VD had higher mean physical HRQoL scores than after CS. The average period to reach full physical recovery was 3 weeks after VD, 6 weeks after elective CS, and >6 weeks after emergency CS. Mean mental HRQoL scores of the study groups were similar or even better compared to reference values. The significant correlation between Hb level and mean physical HRQoL scores found at t=0 had disappeared at 1 week postpartum.
  
  
  CONCLUSIONS
  Results of this study provided insights into the natural course of fatigue and HRQoL postpartum. Important differences in fatigue and HRQoL scores were observed between the 3 modes of delivery. These HRQoL measures can be used in future clinical trials to assess the effects of interventions postpartum.
authors.affiliation: Sanquin Blood Bank South West Region, Rotterdam, The Netherlands.
authors.forename: A J Gerard
authors.initials: AJ
authors.lastname: Jansen
authors.forename: Johannes J
authors.initials: JJ
authors.lastname: Duvekot
authors.forename: Wim C J
authors.initials: WC
authors.lastname: Hop
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Essink-Bot
authors.forename: Erik A M
authors.initials: EA
authors.lastname: Beckers
authors.forename: Veronique H M
authors.initials: VH
authors.lastname: Karsdorp
authors.forename: Sicco A
authors.initials: SA
authors.lastname: Scherjon
authors.forename: Eric A P
authors.initials: EA
authors.lastname: Steegers
authors.forename: Dick J
authors.initials: DJ
authors.lastname: van Rhenen
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000523:psychology*; D015331:Cohort Studies; D036861:Delivery, Obstetric; D005221:Fatigue / Q000523:psychology*; D005260:Female; D006454:Hemoglobins; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000097:blood / Q000523:psychology*; D011788:Quality of Life; D011795:Surveys and Questionnaires
chemical_list: D006454:Hemoglobins