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. 2005 Mar 18;64(10):1494–1499. doi: 10.1136/ard.2004.033019

Impact of pregnancy on health related quality of life evaluated prospectively in pregnant women with rheumatic diseases by the SF-36 health survey

F Forger 1, M Ostensen 1, A Schumacher 1, P Villiger 1
PMCID: PMC1755222  PMID: 15778241

Abstract

Objective: To gain insight into patient experience of the disease course and health related quality of life during and after pregnancy in women with rheumatoid arthritis and ankylosing spondylitis.

Methods: 10 patients with rheumatoid arthritis, 10 patients with ankylosing spondylitis, and 29 age matched healthy pregnant controls were evaluated by the medical outcomes study short form 36 (SF-36) health survey once at each trimester and at 6, 12, and 24 weeks postpartum. A group of non-pregnant age matched female patients (40 rheumatoid arthritis, 16 ankylosing spondylitis) was studied for comparison.

Results: Impaired physical dimensions as well as increased bodily pain was observed in healthy women in late pregnancy. Patients with rheumatoid arthritis showed improved physical functioning scores in the second trimester and reduced pain in the third trimester. Among pregnant patients, those with ankylosing spondylitis suffered the greatest impairment of health related quality of life during pregnancy. In all patient groups the physical impairment in the third trimester was less pronounced than in healthy controls. Mental health scores remained stable even with persisting active disease during pregnancy, or with a postpartum flare.

Conclusions: Pregnancy reduced physical functioning in healthy women and patients, but had no impact on mental and emotional health, even at times of disease aggravation. The pregnancy experience documented in our patients may be helpful when counselling patients contemplating pregnancy.

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Figure 1.

Figure 1

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 Short form 36 item general health survey (SF-36) physical functioning scores during and after pregnancy in healthy controls (A) and in patients with rheumatoid arthritis (B) and ankylosing spondylitis (C). SF-36 scores range from 0 to 100 (0 = worst score, 100 = best scores). Boxes represent the 25th and 75th centiles; horizontal lines within boxes represent the medians; vertical lines above and below boxes represent the distribution beyond the 25th to 75th centile range. *p<0.01 (in healthy controls, significant difference between two time points; in patients with ankylosing spondylitis and rheumatoid arthritis, significant difference from healthy controls); **p<0.001 (in healthy controls, significant difference between two time points, in ankylosing spondylitis patients, significant difference from healthy controls); non-preg = non-pregnant controls, 1 trim = 1st trimester, 2 trim = 2nd trimester, 3 trim = 3rd trimester, 6 wpp = 6 weeks postpartum, 12 wpp = 12 weeks postpartum, 24 wpp = 24 weeks postpartum.

Figure 2.

Figure 2

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 Short form 36 item general health survey (SF-36) bodily pain scores during and after pregnancy in healthy controls (A) and in patients with rheumatoid arthritis (B) and ankylosing spondylitis (C). SF-36 scores range from 0 to 100 (0 = worst score, 100 = best scores). Boxes represent the 25th and 75th centiles; horizontal lines within boxes represent the medians; vertical lines above and below boxes represent the distribution beyond the 25th to 75th centile range. *Significant difference from healthy controls at p<0.01; **significant difference from healthy controls at p<0.001; †significant difference between pooled data of pregnant patients and non-pregnant patients; non-preg = non-pregnant controls, 1 trim = 1st trimester, 2 trim = 2nd trimester, 3 trim = 3rd trimester, 6 wpp = 6 weeks postpartum, 12 wpp = 12 weeks postpartum, 24 wpp = 24 weeks postpartum.

Figure 3.

Figure 3

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 Short form 36 item general health survey (SF-36) general health scores during and after pregnancy in healthy controls (A) and in patients with rheumatoid arthritis (B) and ankylosing spondylitis (C). SF-36 scores range from 0 to 100 (0 = worst score, 100 = best scores). Boxes represent the 25th and 75th centiles; horizontal lines within boxes represent the medians; vertical lines above and below boxes represent the distribution beyond the 25th to 75th centile range. †Significant difference from healthy controls at p<0.05; *significant difference from healthy controls at p<0.01; **significant difference from healthy controls at p<0.001; non-preg = non-pregnant controls, 1 trim = 1st trimester, 2 trim = 2nd trimester, 3 trim = 3rd trimester, 6 wpp = 6 weeks postpartum, 12 wpp = 12 weeks postpartum, 24 wpp = 24 weeks postpartum.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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