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. 2023 Jun;130(7):813-822.
doi: 10.1111/1471-0528.17400. Epub 2023 Feb 7.

Long-term quality of life after obstetric intensive care unit admission: A cross-sectional cohort study

Karishma P Ramlakhan  1   2 , Johanna A van der Zande  1   2 , Jolien W Roos-Hesselink  1 , Arie Franx  2 , Jérôme Cornette  2
Affiliations

Long-term quality of life after obstetric intensive care unit admission: A cross-sectional cohort study

Karishma P Ramlakhan et al. BJOG. 2023 Jun.

Abstract

Objective: To assess the long-term quality of life (QoL) after obstetric Intensive Care Unit (ICU) admission.

Design: Cross-sectional survey study.

Setting: Tertiary care centre.

Population: Women admitted to the level 3 ICU during pregnancy or ≤6 weeks postpartum, between 2000 and 2015.

Methods: Quality of life measures were compared with the population reference values. Associations with baseline ICU parameters were assessed with multivariable linear regression. Patient-reported outcome and experience measures (PROMs/PREMs) were described.

Main outcome measures: Quality of life according to the Linear Analogous Scale (LAS), the Satisfaction with Life Scale (SWLS) and the SF-36 questionnaire; PROMs/PREMs using the Pregnancy and Childbirth outcome set of the International Consortium for Health Outcomes Measurement.

Results: Of all 265 obstetric ICU admissions, 230 were eligible and 94 (41%) were included (median follow-up time 14 years). The LAS (75.7 versus 78.7, p = 0.077) and SWLS (25.2 versus 26, p = 0.176) sum scores were not different from the population reference values. The SF-36 subdomains bodily pain (55.3 versus 73.9), general health (58.2 versus 73.9) and vitality (56.9 versus 69.1) were lower than the reference values (all p < 0.001). PROMs/PREMs were low in 46.2% for pain, 15.1% for depression, 11.8% for satisfaction with care and 52.7% for healthcare responsiveness. An indirect obstetric ICU admission diagnosis was independently associated with a reduced physical health score (B -1.7, 95% confidence interval [CI] -3.4 to -0.1) and severe neonatal morbidity with a reduced mental health score (B -6.6, 95% CI -11.3 to -1.8).

Conclusion: Obstetric ICU admission is associated with reductions in long-term physical health QoL and in some patients with mental health QoL. We suggest multidisciplinary rehabilitation and long-term psychosocial support.

Keywords: intensive care unit; pregnancy complications; quality of life.

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References

REFERENCES

    1. Ramlakhan KP, Gommers D, Jacobs C, Makouri K, Duvekot JJ, Reiss IKM, et al. Women of reproductive age in a tertiary intensive care unit: indications, outcome and the impact of pregnancy - a retrospective cohort study. BMC Womens Health. 2021;21(1):248.
    1. World Health Organization. Evaluating the quality of care for severe pregnancy complications: the WHO near-miss approach for maternal health. Geneva: World Health Organization; 2011.
    1. Say L, Pattinson RC, Gulmezoglu AM. WHO systematic review of maternal morbidity and mortality: the prevalence of severe acute maternal morbidity (near miss). Reprod Health. 2004;1(1):3.
    1. von Rosen IEW, Shiekh RM, McHome B, Chunsen W, Khan KS, Rasch V, et al. Quality of life after maternal near miss: a systematic review. Acta Obstet Gynecol Scand. 2021;100(4):704-14.
    1. Angelini CR, Pacagnella RC, Parpinelli MA, Silveira C, Andreucci CB, Ferreira EC, et al. Quality of life after an episode of severe maternal morbidity: evidence from a cohort study in Brazil. Biomed Res Int. 2018;2018:9348647.

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