Long-term impact of intrauterine fetal death on quality of life and depression: a case-control study.
BACKGROUND
Intrauterine fetal death (IUFD) is a serious incidence that has been shown to impact mothers' psychological well-being in the short-term. Long-term quality of life (QOL) and depression after IUFD is not known. This study aimed to determine the association between intrauterine fetal death and long-term QOL, well-being, and depression.


METHODS
Analyses were performed on collected data among 106 women with a history of intrauterine fetal death (IUFD) and 262 women with live births, 5-18 years after the event. Univariable and multivariable linear and logistic regression models were used to quantify the association between previous fetal death and long-term QOL, well-being and depression. QOL was assessed using the QOL Index (QLI), symptoms of depression using the Center for Epidemiological Studies Depression Scale (CES-D), and subjective well-being using the General Health Questionnaire 20 (GHQ-20).


RESULTS
More of the cases had characteristics associated with lower socioeconomic status and did not rate their health as good as did the controls. The QLI health and functioning subscale score was slightly but significantly lower in the cases than in the controls (22.3. vs 23.5, P = .023). The CES-D depressed affect subscale score (2.0 vs 1.0, P = 0.004) and the CES-D global score (7.4 vs 5.0, P = .017) were higher in the cases. Subjective well-being did not differ between groups (20.6 vs 19.4, P = .094). After adjusting for demographic and health-related variables, IUFD was not associated with global QOL (P = .674), subjective well-being (P = .700), or global depression score (adjusted odds ratio = 0.77, 95% confidence interval 0.37-1.57).


CONCLUSIONS
Women with previous IUFD, of which the majority have received short-term interventions, share the same level of long-term QOL, well-being and global depression as women with live births only, when adjusted for possible confounders.


BACKGROUND
The study was registered at http://www.clinicaltrials.gov, with registration number NCT 00856076.
Department of Haematology, Oslo University Hospital, Ulleval, Oslo, Norway.
Ida Kathrine
IK
Gravensteen
Linda Bjørk
LB
Helgadottir
Eva-Marie
EM
Jacobsen
Per Morten
PM
Sandset
Øivind
Ø
Ekeberg
D000328:Adult; D016022:Case-Control Studies; D003863:Depression / Q000209:etiology / Q000523:psychology*; D059026:Diagnostic Self Evaluation; D005260:Female; D005313:Fetal Death / Q000628:therapy; D006304:Health Status; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008875:Middle Aged; D009035:Mothers / Q000523:psychology*; D015999:Multivariate Analysis; D011247:Pregnancy; D011788:Quality of Life / Q000523:psychology*; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult