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

Abstract

AbstractObjectiveTo assess the long‐term quality of life (QoL) after obstetric Intensive Care Unit (ICU) admission.DesignCross‐sectional survey study.SettingTertiary care centre.PopulationWomen admitted to the level 3 ICU during pregnancy or ≤6 weeks postpartum, between 2000 and 2015.MethodsQuality 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 MeasuresQuality 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.ResultsOf 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).ConclusionObstetric 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.