title: Health-related quality of life after induction of labor versus expectant monitoring in gestational hypertension or preeclampsia at term.
abstract: OBJECTIVE
  Gestational hypertension (GH) and preeclampsia (PE) are major contributors to maternal and neonatal morbidity and mortality. In GH or PE, labor may be either induced or monitored expectantly. We studied maternal health-related quality of life (HR-QoL) after induction of labor versus expectant monitoring in GH or PE at term. We performed the HR-QoL study alongside a multicenter randomized controlled trial comparing induction of labor to expectant monitoring in women with GH or PE after 36 weeks.
  
  
  METHODS
  We used written questionnaires, covering background characteristics, condition-specific issues, and validated measures: the Short-Form (SF-36), European Quality of Life (EuroQoL 6D3L), Hospital Anxiety and Depression Scale (HADS), and Symptom Checklist (SCL-90). Measurements were at the following time points: baseline, 6 weeks postpartum, and 6 months postpartum. A multivariate mixed model with repeated measures was defined to assess the effect of the treatments on the physical component score (PCS) and mental component score (MCS) of the SF-36. Analysis was by intention to treat.
  
  
  RESULTS
  We analyzed the data of 491 randomized and 220 nonrandomized women. We did not find treatment effect on long-term HR-QoL (PCS: p = 0.09; MCS: p = 0.82). The PCS improved over time (p < 0.001) and was better in nonrandomized patients (p = 0.02).
  
  
  CONCLUSIONS
  Despite a clinical benefit of induction of labor, long-term HR-QoL is equal after the induction of labor and expectant management in women with GH or PE beyond 36 weeks of gestation.
authors: Department of Public Health, Academic Medical Centre, Amsterdam, The Netherlands. d.bijlenga@amc.uva.nl
authors: Denise
authors: D
authors: Bijlenga
authors: Corine M
authors: CM
authors: Koopmans
authors: Erwin
authors: E
authors: Birnie
authors: Ben-Willem J
authors: BW
authors: Mol
authors: Joris A
authors: JA
authors: van der Post
authors: Kitty W
authors: KW
authors: Bloemenkamp
authors: Hubertina C
authors: HC
authors: Scheepers
authors: Christine
authors: C
authors: Willekes
authors: Anneke
authors: A
authors: Kwee
authors: Marion H
authors: MH
authors: Heres
authors: Erik
authors: E
authors: Van Beek
authors: Claudia A
authors: CA
authors: Van Meir
authors: Marloes E
authors: ME
authors: Van Huizen
authors: Maria G
authors: MG
authors: Van Pampus
authors: Gouke J
authors: GJ
authors: Bonsel
mesh_terms: D000328:Adult; D005260:Female; D005323:Fetal Monitoring; D006304:Health Status; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000628:therapy*; D007751:Labor, Induced; D011225:Pre-Eclampsia / Q000628:therapy; D011247:Pregnancy; D011788:Quality of Life; D016896:Treatment Outcome