QUALITY-OF-LIFE ASSESSMENT IN PREGNANT-WOMEN WITH THE HUMAN-IMMUNODEFICIENCY-VIRUS

Objective: To describe the perceived quality of life and functional st atus of women with human immunodeficiency virus (HIV) during the anten atal, perinatal, and postpartum periods. Methods: Medical Outcome Surv ey-Short Form questionnaires were completed during antenatal visits, 2 4 hours after delivery, and 6 months postpartum by 21 HIV-positive wom en and 21 HIV-negative controls matched for age, race, parity, and edu cation. The Medical Outcome Survey-Short Form measures subject percept ions of overall health, pain, physical role, social and cognitive func tion, mental health, energy/fatigue, health distress, quality of life, and health transition. Median scores between 0 and 100 (with 0 indica ting poorest health) were compared using the Wilcoxon signed-rank and Kruskal Wallis/Dunn tests. Results: All HIV-positive patients were asy mptomatic; the median CD4 count was 386 on entry into the study. Serop ositive patients reported increased health distress (50.0 versus 87.5; P < .001) and worse health transition (60.0 versus 80.0; P = .01) dur ing antenatal visits. During the perinatal period, HIV-negative patien ts had a decreased sense of overall health (40 versus 80; P < .001) an d worse health transition (40.0 versus 60.0; P = .04). Six months post partum, the HIV-positive women reported decreased cognitive function ( 41.7 versus 62.5; P < .005) and worse social function (33.3 versus 66. 7; P = .02). In general, HIV-negative women reported better quality of life in the antepartum as compared with the perinatal or postpartum p eriod. This overall trend was also seen in the HIV-positive population . Conclusions: This is the first longitudinal evaluation of perceived quality of life in HIV-positive pregnant subjects. We conclude that pe rceived quality of life differs between HIV-positive and HIV-negative pregnant women. These differences may not be manifest during initial a ntenatal visits but may develop as pregnancy, the disease process, and other Life events specific to delivery and the postpartum period inte ract and affect overall perceived quality of life. Longitudinal evalua tion of quality-of-life issues may be important in the comprehensive c are of HIV-positive women during pregnancy. (Copyright (C) 1996 by The American College of Obstetricians and Gynecologists.)