CC BY 4.0 · Rev Bras Ginecol Obstet 2022; 44(05): 475-482
DOI: 10.1055/s-0042-1743092
Original Article
High Risk Pregnancy

Quality of Life of Pregnant Women with Systemic Lupus Erythematosus

Qualidade de vida de mulheres grávidas com lúpus eritematoso sistêmico
1   Departamento de Tocoginecologia, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
1   Departamento de Tocoginecologia, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
1   Departamento de Tocoginecologia, Universidade Estadual de Campinas, Campinas, SP, Brazil
,
2   Departamento de Enfermagem, Universidade de Évora, Évora, Portugal
,
1   Departamento de Tocoginecologia, Universidade Estadual de Campinas, Campinas, SP, Brazil
› Author Affiliations

Abstract

Objective To assess the quality of life (QoL) of pregnant women with systemic lupus erythematosus (SLE) treated at a high-risk prenatal outpatient clinic during the third trimester of gestation.

Methods An observational descriptive study was performed in a high-risk prenatal outpatient clinic. Women in the third trimester of pregnancy and undergoing antenatal care between July 2017 and July 2019 answered the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire, consisting of 26 questions divided into 4 domains (physical, psychological, social and environmental).

Results We interviewed 50 pregnant women with a mean gestational age of 30 weeks (standard deviation [SD]: 10 weeks) who were diagnosed with SLE. The average age of the participants was 30 years (SD: 14.85), and the average time since the diagnosis of SLE was of 9.06 years (SD: 6.8 years). Most participants had a partner, did not plan their pregnancy (76%), and did not use contraception prior to pregnancy (80%). The score of each domain ranges from 0 (the worst score) to 100 (the best score). The means ±  SDs of the scores of the participants on each domain were: physical – 52.21 ±  18.44); psychological – 64.17 ±  18.56); social – 66.33 ±  27.09); and environmental – 64.56 (18.53). The means ±  SDs of the general QoL, and health-related QoL items were of 70.50 ±  24.06 and 70.00 ±  30.72 respectively.

Conclusion The physical domain presented the lowest scores compared with the other three domains. Pregnant women with SLE had high overall QoL scores, and their health-related QoL scores were also relatively high.

Resumo

Objetivo Investigar a qualidade de vida (QV) de gestantes com lúpus eritematoso sistêmico (LES), em acompanhamento ambulatorial pré-natal de alto risco, durante o terceiro trimestre de gestação.

Métodos Foi realizado um estudo observacional descritivo em ambulatório de pré-natal de alto risco. As mulheres em acompanhamento pré-natal no terceiro trimestre de gravidez entre julho de 2017 e julho de 2019 responderam ao questionário abreviado de Qualidade de Vida da Organização Mundial de Saúde (abbreviated World Health Organization Quality of Life, WHOQOL-BREF, em inglês), composto por 26 questões divididas em 4 domínios (físico, psicológico, social e ambiental).

Resultados Foram entrevistadas 50 gestantes com diagnóstico de LES e média de 30 semanas de idade gestacional (desvio padrão [DP]: 10 semanas). A idade média das participantes foi de 30 anos (DP: 14,85), e o tempo médio desde o diagnóstico de lúpus foi de 9,06 anos (DP = 15,55 anos). A maioria das participantes tinha companheiro, não havia planejado a gravidez (76%), e não fazia uso de anticoncepcional antes da gravidez (80%). A pontuação em cada domínios varia de 0 (pior pontuação) a 100 (melhor pontuação). As médias ±  DPs das pontuações das participantes em cada domínios foram: físico – 52,21 ±  18,44; psicológico – 64,17 ±  18,56; social – 66,33 ±  27,09; e ambiental –64,56 ±  18,53). As médias ±  DPs dos itens relativos à QV geral e à QV relacionada à saude foram de 70,50 ±  24,06) e 70,00 ±  30,72, respectivamente.

Conclusão O domínio físico apresentou as menores pontuações em comparação com os outros três domínios. Mulheres grávidas com LES tiveram pontuação alta no item de QV geral, e a pontuação no item de QV relacionada à saúde também foi relativamente alta.

Contributors

All authors contributed to the concept and design of the present study; to the analysis and interpretation of data; to the draft or revision of the manuscript, and they have approved the manuscript as submitted. All authors are responsible for the reported research.




Publication History

Received: 20 January 2021

Accepted: 18 November 2021

Article published online:
17 February 2022

© 2022. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 Borella E, Lojacono A, Gatto M, Andreoli L, Taglietti M, Iaccarino L. et al. Predictors of maternal and fetal complications in SLE patients: a prospective study. Immunol Res 2014; 60 (2-3): 170-176
  • 2 Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR. et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 2012; 64 (08) 2677-2686
  • 3 Lateef A, Petri M. Systemic lupus erythematosus and pregnancy. Rheum Dis Clin North Am 2017; 43 (02) 215-226
  • 4 Pastore DEA, Costa ML, Parpinelli MA, Surita FG. A critical review on obstetric follow-up of women affected by systemic lupus erythematosus. Rev Bras Ginecol Obstet 2018; 40 (04) 209-224
  • 5 Pastore DEA, Costa ML, Surita FG. Systemic lupus erythematosus and pregnancy: the challenge of improving antenatal care and outcomes. Lupus 2019; 28 (12) 1417-1426
  • 6 The WHOQOL Group. Development of the World Health Organization WHOQOL-BREF quality of life assessment. Psychol Med 1998; 28 (03) 551-558
  • 7 Fleck MP, Louzada S, Xavier M, Chachamovich E, Vieira G, Santos L. et al. Aplicação da versão em português do instrumento abreviado de avaliação da qualidade de vida “WHOQOL-bref”. Rev Saude Publica 2000; 34 (02) 178-183
  • 8 Castro GG, Ferreira FF, Camargos AS, Leite MA, Mattos JG. Diferenças da qualidade de vida entre mulheres com alto e habitual risco gestacional. Aletheia 2019; 52 (01) 102-115
  • 9 Oliveira SX, Oliveira MB, Silva RA, Davim RM. Características dos domínios da qualidade de vida em gestantes da estratégia saúde da família. Rev Enferm UFPE On Line 2013; 7 (esp): 7007-716
  • 10 Santos AB, Santos KE, Monteiro GT, Prado PR, Amaral TL. Autoestima e qualidade de vida e uma série de gestantes atendidas em rede pública de saúde. Cogitare Enferm. 2015; 20 (02) 392-400
  • 11 Nascimento SL, Surita FG, Parpinelli MA, Siani S, Pinto e Silva JL. The effect of an antenatal physical exercise programme on maternal/perinatal outcomes and quality of life in overweight and obese pregnant women: a randomised clinical trial. BJOG 2011; 118 (12) 1455-1463
  • 12 Vallim AL, Osis MJ, Cecatti JG, Baciuk EP, Silveira C, Cavalcante SR. Water exercises and quality of life during pregnancy. Reprod Health 2011; 8: 14
  • 13 Rodrigues L, Alves VLP, Sim-Simc MMF, Surita FG. Perceptions of women with systemic lupus erythematosus undergoing high-risk prenatal care: A qualitative study. Midwifery 2020; 87: 102715
  • 14 Ministério da Saúde, Secretaria de Atenção à Saúde. Departamento de Ações Programáticas Estratégicas. Gestação de alto risco: manual técnico. 5a ed.. Brasília (DF): Editora do Ministério da Saúde; 2012. . (Série A. Normas e Manuais Técnicos).
  • 15 Ministério da Saúde, Secretaria de Atenção à Saúde. Manual de acolhimento e classificação de risco em obstetrícia. Brasília (DF): Ministério da Saúde; 2017
  • 16 World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: WHO; 2016
  • 17 Committee on Obstetric Practice. ACOG Committee Opinion No. 731: Group Prenatal Care. Obstet Gynecol 2018; 131 (03) e104-e108
  • 18 American College of Rheumatology Ad Hoc Committee on Systemic Lupus Erythematosus Guidelines. Guidelines for referral and management of systemic lupus erythematosus in adults. Arthritis Rheum 1999; 42 (09) 1785-1796
  • 19 Pedroso B, Pilatti LA, Gutierrez GL, Picinin CT. Calculation of scores and descriptive statistics of WHOQOL-bref through Microsoft Excel. Rev Bras Qual Vida. 2010; 02 (01) 31-6
  • 20 Silva PA, Soares SM, Santos JF, Silva LB. Cut-off point for WHOQOL-bref as a measure of quality of life of older adults. Rev Saude Publica 2014; 48 (03) 390-397
  • 21 Siqueira AL, Tibúrcio JD. Estatística na área da saúde: conceitos, metodologia, aplicações e prática computacional. Belo Horizonte: Coopmed; 2011
  • 22 Ministério da Saúde, Conselho Nacional de Saúde, [Resolution No. 466, 2012 December 12, Approves regulated guidelines and standards for research involving human beings]. Diário Oficial da União. . 2013 Jun 13;Sec. 1:59. Portuguese.
  • 23 Pantzartzis KA, Manolopoulos PP, Paschou SA, Kazakos K, Kotsa K, Goulis DG. Gestational diabetes mellitus and quality of life during the third trimester of pregnancy. Qual Life Res 2019; 28 (05) 1349-1354
  • 24 Iwanowicz-Palus G, Zarajczyk M, Pięta B, Bień A. Quality of life, social support, acceptance of illness, and self-efficacy among pregnant women with hyperglycemia. Int J Environ Res Public Health 2019; 16 (20) 3941
  • 25 Fangtham M, Kasturi S, Bannuru RR, Nash JL, Wang C. Non-pharmacologic therapies for systemic lupus erythematosus. Lupus 2019; 28 (06) 703-712
  • 26 Toloza SM, Sequeira W, Jolly M. Treatment of lupus: impact on quality of life. Curr Rheumatol Rep 2011; 13 (04) 324-337
  • 27 Moraleda V, Prados G, Martínez MP, Sánchez AI, Sabio JM, Miró E. Sleep quality, clinical and psychological manifestations in women with systemic lupus erythematosus. Int J Rheum Dis 2017; 20 (10) 1541-1550
  • 28 Mindell JA, Cook RA, Nikolovski J. Sleep patterns and sleep disturbances across pregnancy. Sleep Med 2015; 16 (04) 483-488
  • 29 Nacar G, Taşhan ST. Relationship between sleep characteristics and depressive symptoms in last trimester of pregnancy. Afr Health Sci 2019; 19 (04) 2934-2944
  • 30 Kalmbach DA, Cheng P, Ong JC. et al. Depression and suicidal ideation in pregnancy: exploring relationships with insomnia, short sleep, and nocturnal rumination. Sleep Med 2020; 65: 62-73
  • 31 Stevens MJ, Walker-Bone K, Culliford DJ, Ciesla JA, Kingsberg SA, Sangha R. et al. Work participation, mobility and foot symptoms in people with systemic lupus erythematosus: findings of a UK national survey. J Foot Ankle Res 2019; 12: 26
  • 32 Kent T, Davidson A, Newman D, Buck G, D'Cruz D. Burden of illness in systemic lupus erythematosus: results from a UK patient and carer online survey. Lupus 2017; 26 (10) 1095-1100
  • 33 Chen Y, Sun G, Guo X, Chen S, Chang Y, Li Y. et al. Factors affecting the quality of life among Chinese rural general residents: a cross-sectional study. Public Health 2017; 146: 140-147
  • 34 Tay KC, Seow CC, Xiao C, Lee HM, Chiu HF, Chan SW. Structured interviews examining the burden, coping, self-efficacy, and quality of life among family caregivers of persons with dementia in Singapore. Dementia 2016; 15 (02) 204-220
  • 35 Byerley BM, Haas DM. A systematic overview of the literature regarding group prenatal care for high-risk pregnant women. BMC Pregnancy Childbirth 2017; 17 (01) 329
  • 36 Krzepota J, Sadowska D, Biernat E. Relationships between physical activity and quality of life in pregnant women in the second and third trimester. Int J Environ Res Public Health 2018; 15 (12) 2745
  • 37 Kang AW, Pearlstein TB, Sharkey KM. Changes in quality of life and sleep across the perinatal period in women with mood disorders. Qual Life Res 2020; 29 (07) 1767-1774
  • 38 Morin M, Vayssiere C, Claris O, Irague F, Mallah S, Molinier L. et al. Evaluation of the quality of life of pregnant women from 2005 to 2015. Eur J Obstet Gynecol Reprod Biol 2017; 214: 115-130
  • 39 Cazella LG, Almeida LY, Oliveira JL, Zanetti AC, Souza J. Qualidade de vida de mulheres e as características sociodemográficas associadas. Enferm Foco. 2019; 10 (03) 34-9