Health-related quality of life among Ethiopian pregnant women during COVID-19 pandemic

Health related quality of life and its predictors among postpartum mother in Southeast Ethiopia: A cross-sectional study

Background

Post-childbirth, woman's health-related quality of life (HRQOL) is significantly impacted, leading to decreased daily activity, reduced self-care, challenges with breastfeeding and baby weaning, and increased medical costs for both mother and newborn.This study aimed to assess the HRQOL and its predictors among postpartum women in Southeast Ethiopia.

Methods

A cross-sectional study was conducted in Southeast Ethiopia between March and May 2022, involving randomly selected sample of 794 postpartum women attending immunization services in public health facilities. Data was collected using a validated questionnaire, and descriptive statistics were computed. A bivariable and multivariable logistic regression model was fitted to predict HRQOL, with odds ratios and 95% confidence intervals used to estimate associations.

Results

The study revealed that the overall HRQOL, physical component summary, and mental component summary of quality of life had mean scores of 43.80 ± 27.88, 45.39 ± 28.58, and 42.20 ± 28.15(mean ± SD) respectively. Walking to the health facility (AOR = 2.09; 95% CI: (1.31,3.31); using public transport (AOR = 2.58; 95% CI = 1.69-3.93); having the fear of COVID-19 (AOR = 1.46; 95% CI = 1.08-1.99); having health facility admission history during the recent pregnancy (AOR = 1.62; 95% CI = 1.08-2.44); having postpartum depression (PPD) (AOR = 2.13; 95% CI = 1.57-2.89) were predictors of a lower level of overall HRQOL among postpartum women.

Conclusion

The study found that nearly half of postpartum women in Ethiopia have lower HRQOL, with factors such as transport use, recent baby's pregnancy admission history, and postpartum depression (PPD) significantly affecting their overall, physical, and mental HRQOL. Fear of COVID-19 was found to be significantly associated with lower overall and physical HRQO. The implementation of appropriate strategies addressing identified factors is crucial for enhancing the HRQOL among postpartum women in Ethiopia.

Predictors Related to Quality of Life in Pregnant Women

Background

Assessment of quality of life (QoL) during pregnancy can be a starting point for streamlining and promoting the humanization of evidence-based healthcare. We aimed to determine the life quality in pregnant women and its predictors.

Methods

A cross-sectional study was conducted on pregnant women from Slovakia from March 2020 to January 2021. A method of purposive sampling was used. The research sample consisted of 393 women (age 29.11±4.65) with physiological pregnancy. Questionnaire method was used. The first part of the questionnaire consisted of a set of questions focused on identification items, which also represented the investigated predictors. The second part was the standardized questionnaire "Quality Of Life-Gravidity Questionnaire"(QOLGRAV), with Cronbach's alpha value of 0.74. The received data were analysed using descriptive and inferential statistics.

Results

The average life quality score was 18.79±5.04, which oscillates at the level of very good life quality. The lower life quality was recorded in connection with physical changes, satisfaction with social life, concerns about childbirth management failure and a need for physical activity reduction. Education (P=0.008), course of pregnancy (P=0.001), support from healthcare professionals (P=0.003) and concerns about COVID-19 (P=0.001) were the predictors of life quality.

Conclusion

The proven significant predictors of life quality of pregnant women have shown that healthcare professionals should pay increased attention to the pregnant women with higher education and with problematic pregnancy, positively support and motivate pregnant women and be even more attentivedue to the current COVID-19 pandemic.

Psychosocial outcomes of the COVID-19 pandemic on pregnant women

The aim of this study was to compare the levels of anxiety and social support evaluated in pregnancy before and during the COVID-19 pandemic. This study was designed prospectively and observationally. Participants were asked to fill in two different questionnaire forms for the Multidimensional Scale of Perceived Social Support and The State-Trait Anxiety Inventory. Independent t-test and Pearson correlation analysis were used for statistical analysis. The mean age of 386 pregnant was 29.1 ± 4.91 years, and the gestational week was 29.12 ± 4.54. The values of the total social support scale were determined 61.52 ± 5.53-51.15 ± 5.86 before and during the pandemic, while the total state anxiety scale was found 39.81 ± 9.04 and 63.38 ± 10.55, respectively. The total trait anxiety scale was found at 38.23 ± 7.39 and 53.22 ± 8.74 in the same respect. A significant difference was obtained in the data between before and during the pandemic (p < .05). The study showed that pregnant are deprived of social support and their anxiety levels increase during the COVID-19 pandemic.IMPACT STATEMENTWhat is already known on this subject? During the COVID-19 pandemic, the prevalence of depression and anxiety in pregnant women have been reported as 25.6 and 30.5%, respectively. Social support is an important determinant of physical and psychological well-being, especially during pregnancy when individuals take on new responsibilities and roles.What do the results of this study add? The study showed that pregnant women were deprived of social support and their anxiety levels increased during this pandemic. The results highlight that there is a high need to mitigate mental health risks and adjust interventions under pandemic conditions.What are the implications of these findings for clinical practice and/or further research? It is necessary to provide social support from family, friends, and close circles. States and health professionals need to put forward serious programs and studies to reduce the stress and anxiety experienced by the society and especially pregnant women and to provide accurate information about COVID-19.

COVID-19 and delayed antenatal care impaired pregnant women's quality of life and psychological well-being: What supports should be provided? Evidence from Vietnam

BACKGROUND

This study explored the associations between different structural and functional supports with the quality of life (QOL) and mental well-being of pregnant women whose antenatal care was delayed due to the COVID-19 pandemic in Vietnam.

METHODS

A multi-center cross-sectional study was performed on 868 pregnant women. The pregnant women's quality of life questionnaire (QOL-GRAV), the Edinburgh Postnatal Depression Scale (EPDS), and the Perinatal Infant Care Social Support (PICSS) instruments were employed. The satisfaction with care from different sources was measured. Multivariate Tobit Regression models were used.

RESULTS

Seventy pregnant women (8.1%) reported that their antenatal care was influenced by the COVID-19. In this group, a higher level of satisfaction with the care of parents-in-law and a higher score of emotional support were associated with a better "Physical and Emotional changes" domain, while a higher level of appraisal support was related to poorer "Physical and Emotional changes" domain. A higher level of satisfaction with relatives' care and a higher score of emotional support were correlated with a better "Life Satisfaction" domain. EPDS score was negatively correlated with satisfaction with parents-in-law care and appraisal support.

CONCLUSIONS

Our study highlighted that intervention programs to improve the QOL and psychological well-being of pregnant women in epidemics such as COVID-19 or other diseases in the future should involve other family members such as parents-in-law and relatives as sources of support.

LIMITATIONS

The cross-sectional design was unable to draw causal relationships. Recall bias might occur. The convenient sampling method might limit the generalizability of findings.

Compliance with COVID-19 Preventive Measures and Associated Factors Among Women Attending Antenatal Care at Public Health Facilities of Debre Berhan Town, Ethiopia

BACKGROUND

Coronavirus disease-2019 (COVID-19) is a highly contagious and cause for the death of many people worldwide. Due to physiological immunosuppressive state and mechanical alteration, pregnant women are at a higher risk of severe illness and adverse maternal and fetal outcomes from COVID-19 than non-pregnant women. Compliance with the preventive measures is essential to control COVID-19 related consequences. Therefore, this study aimed to assess compliance with COVID-19 preventive measures among pregnant women attending antenatal care at public facilities of Debre Berhan town, Ethiopia.

METHODS

A facility-based cross-sectional study was conducted from May 1 to 30, 2021 among 402 pregnant mothers. Data were collected via a face-to-face interviewer-administered questionnaire. Then, entered into Epi-Data version 4.6 and exported to SPSS version 25 for data analysis. In multivariable logistic regression analysis, variables with p < 0.05 were declared as statistically significant and the strength of statistical association was measured by adjusted odds ratio (AOR) and 95% confidence interval (CI).

RESULTS

Of the total 396 participants, 222 (56.1%) of women had a good compliance with COVID-19 preventive measures. Maternal age (25-34 years) [AOR: 1.926; 95% CI (1.084, 3.421)] and (≥35 years) [AOR: 3.018; 95% CI (1.53, 5.952)], husband educational status [AOR: 3.68; 95% CI (1.55, 8.737)], had current chronic disease [AOR: 2.516; 95% CI (1.297, 4.883)], and knowledge [AOR: 5.484; 95% CI (3.057, 9.838)] were significant predictors to have good compliance with COVID-19 preventive measures.

CONCLUSION

Although COVID-19 is a global and national agenda, compliance towards its preventive measures was not sufficient enough. Therefore, scale-up the community awareness via media campaign is crucial which will eventually improve compliance. Furthermore, those women who had no pre-existing chronic diseases and those in the young age group should be given special consideration.

Psychological Distress Among Ethiopian Pregnant Women During COVID-19: Negative Correlation with Self-Efficacy

BACKGROUND

Since the onset of coronavirus disease 2019, the mental health of individuals has been negatively affected, especially among vulnerable groups.

OBJECTIVE

The aim of this study was to explore the association of psychological distress with self-efficacy and other correlates among Ethiopian pregnant women.

METHODS

A cross-sectional study was carried out among 384 pregnant women from August 1 to 15, 2020. Pandemic-related psychological distress was measured by the Impact of Event Scale Revised (IES-R). Hospital anxiety and depression scale (HADS), generalized self-efficacy scale (GSES), and fear of COVID-19 scale (FCoV-19S) were employed to examine independent variables. A consecutive sampling technique was employed and the data were analyzed by SPSS version 23.0. Categorical variables were presented in terms of frequencies and percentages; and mean with SD was employed to express continuous variables. Multiple regressions were performed; and for statistical significance, p < 0.05 and 95% CI were considered.

RESULTS

The participants had 31.3 (SD±7.7) mean age and those participants between the ages of 25-34 were dominant. The mean score of IES-R scale was 45.1 (±17.4) indicating severe psychological distress. The IES-R mean score for primiparous women was significantly higher than the mean score of multiparous women. Psychological distress has a strong positive correlation with symptoms of anxiety, depression and fear of COVID-19. In contrast, a negative relationship was found between psychological distress and participants' self-efficacy.

CONCLUSION

The results indicate that the current pandemic has imposed severe psychological distress among pregnant women. The presence of anxiety, depressive symptoms, and pandemic-related fears were identified as positive predictors. In contrast, better self-efficacy of the pregnant women was linked to lower psychological distress. For health-care professionals, broadening the focus and collaboration among service-delivering units are important in halting undesirable outcomes of the pandemic.