title: Immediate and long-term relationship between severe maternal morbidity and health-related quality of life: a prospective double cohort comparison study.
abstract: Given the growing interest in severe maternal morbidity (SMM), the need to assess its effects on quality of life is pressing. The objective of this study was to compare the quality of life scores between women with and without SMM at 1-month and 6-month postpartum in Kelantan, Malaysia.
  
  
  
  A prospective double cohort study design was applied at two tertiary referral hospitals over a 6-month period. The study population included all postpartum women who delivered in 2014. Postpartum women with and without SMM were selected as the exposed and non-exposed groups, respectively. For each exposed case identified, a non-exposed case with a similar mode of delivery was selected. The main outcome measures used were scores from the Short Form-12 Health Survey (SF-12).
  
  
  
  The study measured 145 exposed and 187 non-exposed women. The group-time interaction of the repeated measure analysis of variance (RM ANOVA) showed no significant difference in the mean overall SF-12 physical component summary score changes (P = 0.534) between women with and without SMM. Similarly, the group-time interaction of the RM ANOVA showed no significant difference in the mean overall SF-12 mental component summary score changes (P = 0.674) between women with and without SMM. However, women with SMM scored significantly lower on a general health perceptions subscale at 1-month (P = 0.031), role limitations due to physical health subscale at 6-month (P = 0.019), vitality subscale at 1-month (P = 0.007) and 6-month (P = 0.008), and role limitations due to emotional problems subscales at 6-month (P = 0.008).
  
  
  
  Women with severe maternal morbidity demonstrated comparable quality of life during the 6-month postpartum period compared to women without severe maternal morbidity.
authors.affiliation: Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia. hayatikk@usm.my.
authors.forename: Mohd Noor
authors.initials: MN
authors.lastname: Norhayati
authors.affiliation: Women's Health Development Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150, Kota Bharu, Kelantan, Malaysia.
authors.forename: Nik Hussain
authors.initials: NH
authors.lastname: Nik Hazlina
authors.affiliation: Faculty of Medicine, Universiti Sultan Zainal Abidin, 20400, Kuala Terengganu, Terengganu, Malaysia.
authors.forename: Abd Aziz
authors.initials: AA
authors.lastname: Aniza
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D015331:Cohort Studies; D036861:Delivery, Obstetric; D005260:Female; D006306:Health Surveys; D006801:Humans; D008296:Malaysia; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*
keywords: Prospective double cohort; Quality of life; Severe maternal morbidity; Short Form-12 Health Survey