(667) Evaluating maternal quality of life following a periviable delivery

Friday, February 10, 2023

10:30 AM – 12:00 PM

Objective: Data on long-term maternal quality of life (QOL) following a periviable delivery are lacking. We investigated QOL measures among patients who delivered a periviable infant.

Study Design: Retrospective cohort study of patients who delivered between gestational ages 22 0/7 - 25 6/7 at a single institution from 2013-2019. Trained personnel contacted eligible participants by phone and administered the validated World Health Organization Quality of Life Instrument (WHOQOL-BREF). Patients who had a surviving infant discharged from the hospital were compared with those who had an intrauterine or neonatal demise. Baseline characteristics were summarized, and scores were evaluated based on the 4 prespecified domains: physical health, psychological, social relationships, and environment.

Results: A total of 58 patients participated: 32 with a surviving infant and 26 with a demise. Maternal age was lower in the surviving infant cohort (25.2 ± 3.9 vs 29.0 ± 6.0, p< 0.01). Race, insurance status, maternal medical conditions, marital status, and delivery mode did not differ. Mean duration from delivery to study start date did not differ (5.1 ± 2.0 vs 4.5 ± 2.1 years, p=0.31). Complications in surviving infants included intraventricular hemorrhage (44%), necrotizing enterocolitis (16%), retinopathy of prematurity requiring treatment (37%), pulmonary hypertension (28%), respiratory support at discharge (56%), and concern for cerebral palsy (31%). Higher scores indicate higher QOL. Patients with surviving infants scored higher in the WHOQOL-BREF psychological and social relationship domains compared to those who had a demise. Patients with a surviving infant were more likely to be satisfied with their own health (4.3 ± 0.7 vs. 3.8 ± 0.8, p=0.02), but reported a similar QOL (Table). Additionally, patients who experienced a demise were less likely to be satisfied with their health, finances, sleep, sex life, and social support.

Conclusion: Patients with an infant who survives a periviable birth, despite possible long term health complications for the infants, appear to have an improved quality of life in some domains.

Primary & Presenting Author(s)

Angela R. Seasely, MD, MS (she/her/hers)
Fellow
Center for Women’s Reproductive Health, University of Alabama at Birmingham
Birmingham, Alabama, United States

Coauthor(s)

CB
Christina T. Blanchard, MS
Statistician
Center for Women’s Reproductive Health, University of Alabama at Birmingham
Birmingham, Alabama, United States
AC
Abigail Cooley, BS
University of Alabama at Birmingham School of Medicine
Birmingham, Alabama, United States
DB
Danyon Beitel, BS
University of Alabama at Birmingham School of Medicine
Birmingham, Alabama, United States
JW
Juliann Wang, BS
University of Alabama at Birmingham School of Medicine
Birmingham, Alabama, United States
CT
Colm P. Travers, MD
Assistant Professor
Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham
Birmingham, Alabama, United States
BS
Brian Sims, MD, PhD
Professor
Department of Pediatrics, Division of Neonatology, University of Alabama at Birmingham
Birmingham, Alabama, United States
Alan T. Tita, MD, PhD
Professor
University of Alabama at Birmingham
Birmingham, Alabama, United States
BC
Brian M. Casey, MD
Center for Women's Reproductive Health, University of Alabama at Birmingham
Birmingham, Alabama, United States
Rachel Sinkey, MD (she/her/hers)
Center for Women's Reproductive Health, University of Alabama at Birmingham
Birmingham, Alabama, United States