Health-related quality of life in different trimesters during pregnancy

Health-related quality of life and utility of maternity health states amongst post-partum Australians

BACKGROUND

This study aimed to measure patient-reported health-related quality of life amongst post-partum women in Queensland, Australia.

METHODS

Patient-reported health-related quality of life data was prospectively collected from 134 post-partum women using the EQ-5D-5L at weekly intervals during the first six weeks following birth. Data across the five health domains of the EQ-5D-5L was converted to a single health utility value to represent overall health status. Linear mixed modelling and regression analysis were used to examine changes in utility over the first six weeks post-birth and determine associations between utility and clinical and demographic characteristics of post-partum women.

FINDINGS

Gestation at birth and weeks post-partum were significantly associated with utility values when considered in a multivariate linear mixed model. Mean utility values increased by 0.01 for every week increase in gestation at birth, and utility values were 0.70 at one week post-partum and increased to 0.85 at six weeks post-partum, with the largest increase occurring between one- and two-weeks post-birth. When controlling for variables that were found to predict utility values across the first six weeks post-partum, no single state of health predicted utility values at one-week post-partum.

CONCLUSIONS

Maternity services can use our data and methods to establish norms for their own service, and researchers and maternity services can partner to conduct cost-effectiveness analysis using our more relevant utility values than what is currently available. Time since birth and gestational age of the woman's baby should be considered when selecting post-partum health state utility values for maternity services cost-effectiveness analyses.

Quality of life and social support during pregnancy in Spanish population. A longitudinal study

BACKGROUND

The quality of life and social support during pregnancy are two variables influencing the health of pregnants and neonates. The documented impact of these variables on mental health, specifically the risk of depression, is notable.

AIM

To investigate the evolution of quality of life and social support at the beginning and end of pregnancy in pregnant women, and to examine the relationship between these variables.

METHODS

The proposed longitudinal study includes 188 pregnants from a northern region of Spain. Participants were selected through consecutive sampling from September 2021 to April 2023. Quality of life and social support will be assessed in the first and third trimesters of pregnancy using the SF-36 questionnaire and MOS-SSS questionnaire, respectively.

FINDINGS

The questionnaires show strong internal consistency (α = 0.91 and 0.97). Quality of life changes during pregnancy, declining in the physical component and rising in the mental component towards the end. Primiparous women have higher quality of life. Depression risk is 29.8 % in the 1st trimester, dropping to 22.9 % in the 3rd trimester. Social support decreases in the 3rd trimester, particularly among unmarried women. Significant positive correlations exist between quality of life and social support.

CONCLUSION

This study emphasizes notable variations in quality of life and social support during pregnancy, impacting the health of pregnant individuals and neonates. Proposing standardization in monitoring these factors during prenatal check-ups aims to improve the physical and mental health of pregnant individuals and newborns.

Effectiveness of a nurse-led family empowerment program to improve the quality of life among pregnant adolescents: A randomized controlled trial

OBJECTIVE

The present study examined the effects of a nurse-led family empowerment program on the quality of life of Palestinian pregnant adolescents.

METHODS

This was a randomized controlled trial with a two-group pre-/post-test design. The sample consisted of 58 pregnant adolescents recruited from six governmental primary health care clinics in Palestine. Participants were randomly allocated in equal numbers to either the control group (n = 29), which received routine care, or the experimental group (n = 29), which received both routine care and the study program. Data collection instruments included a demographic form and the WHO Quality of Life-BREF (WHOQoL-BREF). Data were collected twice: at 32 or 33 weeks' gestation to establish a baseline and at 36 or 37 weeks' gestation post-test. Statistical analyses were performed and included descriptive statistics, chi-square and t-tests.

RESULTS

The study findings indicated a significant increase in the mean quality of life scores of the experimental group in the post-test compared to the pre-test (P < 0.001). Additionally, pregnant adolescents in the experimental group demonstrated significantly higher post-test QoL scores than those in the control group (P < 0.001).

CONCLUSION

The nurse-led family empowerment program emerges as a viable and efficacious alternative intervention for improving the quality of life among Palestinian pregnant adolescents.

CLINICALTRIALS

The study was registered with the NIH U.S. National Library of Medicine ClinicalTrials.gov on 01/09/2021 with the registration code NCT05031130. It can be accessed via this link: https://classic.

CLINICALTRIALS

gov/ct2/show/NCT05031130.

Experience Counts: Unveiling Patients' Willingness to Pay for Remote Monitoring and Patient Self-Measurement

OBJECTIVES

This study aimed to (1) estimate patients' willingness to pay (WTP) for remote monitoring (RM) and patient self-measurement (PSM) for pregnant women at risk of gestational hypertensive disorders, (2) assess the impact of experience with these technologies on WTP, and (3) determine their impact on health-related quality of life (HRQoL).

METHODS

Data collection was part of a multicentric randomized controlled trial, Pregnancy Remote Monitoring II, with 2 interventions: RM and PSM. A contingent valuation survey, combining a payment card and open-ended question, was completed twice by 199 participants. Two-part models analyze the impact of experience on WTP, regression models estimated using ordinary least squares the impact of RM and PSM on HRQoL.

RESULTS

The mean WTP amount was approximately €120 for RM and €80 for PSM. Compared with having no experience, WTP RM was €63 higher after a long-term exposure to RM (P = .01) and WTP PSM was €26 lower after a short-term exposure to RM (P = .07). No significant impact of RM or PSM on HRQoL was found.

CONCLUSIONS

This study contributes to the discussion on the impact of experience on WTP. Those who had a long-term experience with RM, were willing to pay more for RM than those without experience. This confirms our hypothesis that involving patients without experience with the valued treatment, possibly underestimates WTP. A long-term experience has, however, no impact on the WTP for technologies for which the potential benefits are apparent without experiencing them, such as PSM.

Health-related quality of life among Moroccan women after vaginal birth and cesarean section: Cross-sectional study

Background

During the postpartum period, understanding women's well-being, specifically their Health-related Quality of Life (HRQoL), is vital for comprehensive healthcare.

Objectives

Our study aims to explore the HRQoL and its associated factors in Moroccan women after vaginal birth (VB) and cesarean section (CS).

Study design

In this cross-sectional study we assessed the HRQoL and its associated factors among Moroccan women who gave birth at the provincial hospital center of Settat. We gathered data from 566 women, using the EQ-5D-5L instrument alongside questionnaires about socioeconomic and obstetrical aspects. The assessment was conducted utilizing the improved Relative to an Identified Distribution (RIDIT) approach, and we employed a multiple linear regression model to pinpoint the associated factors.

Results

A total of 566 women were included in our study. Our results revealed that the HRQoL in women who underwent CS was significantly lower than in VB women (EQ-5D index score = 0.30 ± 0.28 vs 0.61 ± 0.31; p < 0.0001). Similarly, the CS reduced the EQ-VAS score (mean difference = -10.73 ± 3.78; p < 0.0001). The CS was associated negatively with problems in mobility (ARI = 55 % [42-67], p < 0.0001), autonomy (ARI = 67 % [57-80], p < 0.0001), and usual activities (ARI = 56 % [42-69], p < 0.0001). Also, CS was associated with pain/discomfort (ARI = 47 % [34-60], p < 0.0001) and anxiety/depression (ARI = 3 % [-5.8-12.6], p = 0.31). The women who had birth complications had the worst HRQoL (EQ-5D index score = 0.32) compared to those who had no complications (EQ-5D index score = 0.56). Likewise, women who had postpartum complications had the worst HRQoL (EQ-5D index score = 0.39 vs EQ-5D index score = 0.54).

Conclusion

The results highlighted that mode of birth, childbirth complications, and postpartum complications are strongly associated with women's HRQoL. The EQ-5D-5L dimensions were affected after delivery. Hence, there is a requirement to create specialized initiatives for overseeing postpartum HRQoL, aiming to enhance the quality of maternal healthcare.

Effectiveness and safety of acupuncture in treatment of pregnancy-related symptoms: a systematic review and Meta-analysis

OBJECTIVE

To systematically evaluate the efficacy and safety of acupuncture (AM) in the treatment of pregnancy-related symptoms such as acute vomiting during pregnancy.

METHODS

We comprehensively searched the available literature up to November 2021, including PubMed, Embase, Cochrane Library, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure Database, for randomized controlled trials (RCTs) on AM for the treatment of severe vomiting, insomnia, pharyngeal and pelvic pain, mood abnormalities, and dyspepsia during pregnancy.

RESULTS

Sixteen RCTs with a cumulative sample size of 1178 cases were included. Of these, 964 patients were included in the Meta-analysis. The Meta-analysis results showed that AM was more efficient than Western medicine in treating discomfort during pregnancy [odds ratio (OR) = 1.19, 95% confidence interval (CI) (1.11, 1.28), P < 0.01]. AM was better than the control group in improving the visual analog scale scores [standard mean difference (SMD) = 0.62, 95% CI(0.53, 0.71), P < 0.01]. AM was superior to the control group in improving Numerical Rating Scale (NRS) symptom scores [OR = 7.31, 95% CI(3.36, 15.94), P < 0.01]. There was no significant difference in adverse effects between the AM and sham-AM groups and the analgesic drug group [OR = 0.70, 95% CI(0.39, 1.28), P = 0.25], but the treatment and control groups had mild adverse effects with a low incidence.

CONCLUSIONS

AM is more effective than other treatments or pharmacotherapy alone in the treatment of pregnancy-related symptoms, and is relatively safe. However, the quality of the included trials was rather poor, and high-quality studies are required to confirm our findings.

Self-reported quality of life before, during, and after pregnancy in women with CHD

BACKGROUND

Adults with CHD are a growing patient group and childbirth is a relatively new phenomenon. EQ-5D is commonly used to measure health-related quality of life. We sought to investigate EQ-5D status before, during, and after pregnancy in women with CHD.

METHODS

We identified 128 pregnancies in 86 CHD women giving birth in Skåne County during 2009-2021. Repeated measures ANOVA was performed to test for differences between the five EQ-5D domains, EQ-VAS, and EQ-index over time points before, the second trimester, the third trimester, and after pregnancy.

RESULTS

Mean age at estimated childbirth was 30.3 (± 4.7) years; 56.25% of births were vaginal deliveries and 43.75% were Caesarean sections. The cohort consisted of patients with double outlet right ventricle (4.7%), transposition (Mustard/Senning 2.3%, arterial switch 4.7%), aortic anomalies (19.5%), Fallot's anomaly (16.4%), single ventricle (3.9%), shunt lesions (11.7%), cardiomyopathies (4.7%), coronary anomalies (1.6%), arrythmias (0.8%), and valve lesions: aortic (19.5%), mitral (5.5%), and pulmonary (4.7%). The women reported significantly worse mobility (p = 0.007) and higher pain/discomfort (p = 0.049) at trimester 3 compared to before pregnancy. The women had lower EQ-5D index during trimester 3 compared to after pregnancy (p = 0.004). We saw worse mobility during Tri 2 comparing multiparity with primiparity (p = 0.046). Looking at delivery mode, we noted significantly higher anxiety/depression before pregnancy (p =0.023) in women that had a Caesarean section.

CONCLUSIONS

In this study, women with CHD reported worse mobility and a higher pain level during Tri 3, although the overall health-related quality of life is acceptably high.

Better safe than sorry: Exploring the collective sensemaking process in pregnancy virtual communities through thematic analysis

Physical symptoms induced by pregnancy are often perceived as a normal part of the physiological process and therefore not commonly discussed in clinical settings during prenatal care. This study aimed to explore how pregnant individuals adapt to physical symptoms related to their pregnancy, using the perspective of collective sensemaking. A retrospective study design with an inductive thematic analysis approach of qualitative data extracted from web-based forum posts was conducted. Among 574 initial posts and 2801 comments, three themes were identified: (i) awareness of changing pregnancy body, (ii) uncertainty about physical symptoms, and (iii) coping with discomforts associated with pregnancy. A shared identity as a group of individuals dealing with similar challenges enables pregnant individuals to develop a better comprehension of their experiences. Healthcare professionals should recognize the importance of individual and collective sensemaking in pregnancy forums and strive to provide a supportive and empathetic environment for pregnant individuals to share their experiences and seek guidance.

Physical Activity and Self-Perception of Mental and Physical Quality of Life during Pregnancy: A Systematic Review and Meta-Analysis

Self-perception of health status (quality of life) is considered one of the best indicators of health and well-being. However, during pregnancy, it could be impacted not only by physiological and anatomical changes, but by poor lifestyle habits like high sedentary behaviour or bad nutrition. This study assesses the effects of physical activity RCT interventions during pregnancy on both mental and physical components of quality of life. A systematic review and two meta-analyses were performed (PROSPERO registration number: CRD42022370467). Of the 207 articles captured both in English and Spanish, seven articles were deemed eligible for inclusion. The two analyses performed found that physically active pregnant women had better scores of mental self-perception of quality of life (z = 2.08, p = 0.04; SMD = 0.34, 95% CI = 0.02, 0.67, I2 = 76%, Pheterogeneity = 0.0004) and in physical self-perceived health status (z = 2.19, p = 0.03; SMD = 0.33, 95% CI = 0.03, 0.63, I2 = 71%, Pheterogeneity = 0.002) compared to control group pregnant women. Physical activity interventions could potentially increase mental and physical self-perception of quality of life during pregnancy.

Health-Related Quality of Life in Pregnant Women during the First Trimester in Northern Spain: A Descriptive Cross-Sectional Study

BACKGROUND

Achieving the optimal quality of life is currently a health challenge for the world's population. Pregnancy is a stressful period of life that affects women's quality of life.

AIMS

This study aimed to describe and analyse the health-related quality of life in pregnant women during their first trimester in a health area in the north of Spain.

METHODS

A cross-sectional descriptive study was carried out. A total of 359 women completed the 36-Item Short-Form Health Survey.

RESULTS

The sample consisted of 57.9% primiparous women, 30% had experienced a previous abortion, and 7.2% were foreign women. The mean age was 33.53 years. The sum of the physical and mental component values was below 50 points. Notably, 4.17% of women reported a worsening of their health in the last year, and 28.69% had an increased depression risk.

CONCLUSION

Being a foreigner, prenatal abortion, previous caesarean section, previous children, or assisted reproduction techniques are the variables that have a negative association with some dimensions of quality of life in pregnant women.

Measurement of Health-Related Quality of Life from Conception to Postpartum Using the EQ-5D-5L Among a National Sample of US Pregnant and Postpartum Adults

BACKGROUND

During pregnancy, physiological changes occur from conception to birth. We assessed the health-related quality of life (HRQoL) throughout pregnancy and postpartum using the EQ-5D-5L.

METHODS

Between May and July 2021 (wave 1) and December 2021 and April 2022 (wave 2), we conducted a series of cross-sectional, national online surveys of 5250 pregnant and postpartum United States (US) adults. The survey included the EQ-5D-5L, EQ visual analog scale (EQ VAS), items measuring respondents' sociodemographic and health information, last menstrual period, estimated date of delivery, and date of pregnancy end (if postpartum). We examined monthly EQ-5D-5L items, utility values, and EQ VAS scores during pregnancy and postpartum. We used quantile regression adjusted for calendar month of last menstrual period to estimate changes in HRQoL at different time points of pregnancy and postpartum.

RESULTS

There was a steady increase in the frequency of respondents reporting health-related problems and a decline in EQ-5D-5L utility values from early pregnancy until the ninth month of pregnancy (β = - 0.21; standard error [SE] 0.02; P < 0.001), followed by a 0.10 (SE 0.02; P < 0.001) unit increase in values during the first postpartum month and a stabilization during the remainder of the postpartum period (β = 0.02; SE 0.02; P = 0.214). The median EQ-5D-5L utility value was lowest during the ninth month of pregnancy (median 0.78 [interquartile range 0.30]).

CONCLUSIONS

HRQoL as measured by EQ-5D-5L varies across pregnancy, indicating progressive declines throughout pregnancy and a return to first trimester values during the first month postpartum. Studies involving HRQoL measurement in pregnant people should account for the stage of pregnancy in their estimates.

Feasibility, acceptability, and preliminary efficacy of yoga to improve maternal mental health and immune function during the COVID-19 crisis (Yoga-M2 trial): a pilot randomized controlled trial

Introduction

Women are vulnerable during pregnancy as they experience multiple physical and psychological problems which can lead to stress and poor quality of life ultimately affecting the development of the fetus and their health during and after pregnancy. Prior evidence suggests that prenatal yoga can improve maternal health and well-being and can have a beneficial effect on immune system functioning. To date, no study has been conducted in a rural, low-resource setting in India to assess the feasibility, acceptability, and preliminary efficacy of a yoga-based intervention on perceived stress, quality of life, pro-inflammatory biomarkers, and symptoms of upper respiratory tract infections.

Methods

To address this gap and assess whether a yoga-based intervention could improve maternal mental health and immunity during the COVID-19 crisis (Yoga-M2 trial), a single-blind individual randomized parallel group-controlled pilot trial with a 1:1 allocation ratio was implemented. We randomly allocated 51 adult pregnant women, with gestational age between 12-24 weeks in the Yoga-M2 arm (n = 25) or the enhanced usual care arm (EUC) (n = 26). Feasibility and acceptability were assessed using the process data and In-Depth Interviews (IDIs) with the trial participants and yoga instructors. Multiple linear regression was used to compare follow-up scores for quantitative outcomes.

Results

A three-month follow-up assessment was completed for 48 out of 51 participants (94.12%). We did not find any statistically significant difference between both arms in total Perceived Stress Scale scores, quality of life (Eq-5D-5L index), and serum C Reactive Protein levels at the three-month follow-up assessment. The critical barriers to practicing yoga were lack of knowledge about the benefits of yoga, lack of 'felt need' to practice yoga, lack of time to practice, lack of space, lack of transport, and lack of peer group to practice yoga. Despite this, women who regularly practiced yoga described the benefits and factors which motivated them to practice regularly.

Discussion

The learnings from this trial will help design the explanatory trial in the future and the study findings can also be used by the primary health care system to deliver yoga-based interventions in the newly created health and wellness centers.

Trial registration

This trial was prospectively registered with the Clinical Trials Registry of India on 25 January 2022. https://www.ctri.nic.in/Clinicaltrials/showallp.php?mid1=65173&EncHid=&userName=CTRI/2022/01/039701. Trial registration number: CTRI/2022/01/039701.

Valuing live births from assisted reproduction: A health economics viewpoint

Infertility is a medical condition that can be overcome, thanks to advances in medically assisted reproductive (MAR) therapies. Despite the ultimate measure of MAR efficacy being the birth of a new human being, there are ethical and methodological questions as to which outcome best translates the value of MAR in cost-effectiveness analyses. Many authors favour cost per life birth outcomes instead of more traditional cost per quality-adjusted life years (QALYs), which raises generalizability issues for decision-makers. Nonetheless, infertility and infertility treatments substantially differ from other health conditions and health treatments, particularly in the way they affect the quality of life of the infertile couple. Collecting quality of life measures in infertility and pregnancy is also surrounded by challenges not easily overcome. We reflect on cost-effectiveness methods applied to MAR technologies, on ethical considerations for valuing a MAR-generated life, and on its broader societal value for consideration by decision-makers.

Assessing the Validity of the Long-Term Conditions Questionnaire (LTCQ) in Women During Pregnancy and the First Year Following Birth

Background

The aim of this study was to validate a generic patient-reported outcome measure, the Long-Term Conditions Questionnaire (LTCQ), among pregnant and postpartum women living with a pre-existing long-term condition (LTC).

Methods

Cognitive interviews were conducted with women who were currently pregnant or had given birth within the past year and living with a pre-existing LTC (n=11) and with healthcare professionals working in maternal care (n=11) to explore the acceptability of LTCQ items. An online survey was subsequently administered among women who were pregnant or had given birth within the past year and living with a pre-existing LTC (n=718). Tests of validity were performed including assessing correlations between the LTCQ and reference measures, the Well-being in Pregnancy (WiP) Questionnaire and the EuroQol EQ-5D-5L. Internal consistency was assessed using the Cronbach's alpha statistic.

Results

All LTCQ items were considered relevant and appropriate for use with women who were pregnant or had given birth within the past year. The most commonly reported LTC among the online survey sample (n=718) was a mental health condition (n=350, 48.7%) followed by joint, bone and connective tissues (n= 212, 29.5%) and gastrointestinal (n=143, 19.9%) condition. Data indicated LTCQ scores behaved in a predictable pattern, demonstrating poorer scores for women reporting a greater number of LTCs; mean (SD) scores, one LTC= 61.86 (17.8), two LTCs= 55.29 (16.0), three LTCs= 49.84 (15.52) and four LTCs= 44.94 (12.2). Poorer scores were also reported for women living with at least one mental health condition compared to those reporting no mental health condition, mean score = 66.18 (SD 16.7) v 48.64 (SD 13.3), p<0.001 respectively. As anticipated, LTCQ scores demonstrated significant correlations in the expected direction with both the EQ-5D-5L and WiP scores. For all LTCQ items, the Cronbach's alpha statistic was 0.93.

Conclusion

Data presented here indicate that the LTCQ, which assesses living well with one or more LTC, is suitable for use among pregnant and postpartum women, from both the woman's perspective and from the perspectives of maternity healthcare professionals. Use of the LTCQ would facilitate the identification of unmet needs within this high-risk cohort and support the exploration of how LTCs may affect women throughout the pregnancy and post-natal period. Understanding unmet needs within this cohort of women provides an opportunity to link up specialist care within maternity services and enhance personalised care.

The Quality of Life among Women with Pre-eclampsia: A Pilot Descriptive Study

Introduction: Preeclampsia is a severe life event that has the potential to alter a woman's quality of life. This study sought to determine the quality of life among women with preeclampsia. Method: This study uses a descriptive study. Using total sampling methods, participants diagnosed and hospitalized with preeclampsia were invited to complete a survey about their demographics and the Quality of Life Instrument for Chronic Disease - Hypertension (QLICD-HY) Questionnaire. Results: 35 eligible participants with mean age of 33.2±5.83 were included in the present study. In Indonesia, most women with pre-eclampsia have a high quality of life. The sub-analysis found that many women with pre-eclampsia have a high quality of life in all domains (physical, psychological, and social). Age, education, occupation, family income, pregnancy stage, gravida, and medication adherence had a significant relationship with quality of life (p< 0.05). Conclusion: Women with preeclampsia generally describe a high quality of life. Nonetheless, there is still improvement to be made in preventing and treating preeclampsia patients to optimize quality of life. Keyword: Preeclampsia; pregnancy; quality of life  

Women during Lactation Reduce Their Physical Activity and Sleep Duration Compared to Pregnancy

Sleep, mental health and physical activity are fundamental for wellbeing, and some of these factors are interrelated. However, these aspects are not usually considered during pregnancy and lactation, which are particularly vulnerable periods. Therefore, our aims were to conduct a cross sectional study to assess the psychological capital, quality of life, sleep hygiene and physical activity in a cohort of women during pregnancy and lactation periods. Women were recruited from Spanish maternity and lactation non-profit associations and social networks through an online platform with the following inclusion criteria: pregnancy (in any period of gestation) or breastfeeding period (≤6 months postpartum). The cohort was categorized into ≤12 weeks of gestation (n = 32), >12 weeks of gestation (n = 119) and lactation (n = 60). The women self-reported the sociodemographic data, obstetric complications and full breastfeeding or mixed practices. In addition, women responded to the psychological capital instrument, the health survey form, the Pittsburg sleep quality index and the pregnancy physical activity questionnaire. Overall, the groups were similar in sociodemographic variables. Women in the lactation period perceived lower social support compared to the gestation period. No statistically differences were found between groups in the psychological capital nor in the general health survey form. However, the models adjusted by employment and civil and economic status and perceived social support, demonstrated that the sleep duration negatively associated with the lactation period (β = 1.13 ± 0.56; p-Value = 0.016), and the household tasks were associated with this period (β = 2147.3 ± 480.7; p-Value < 0.001). A decrease in physical daily activities were associated with both the end of gestation and the lactation periods. In addition, the decreasing total activity was associated with the lactation period (β = 1683.67 ± 688.05; p-Value = 0.016). In conclusion, during lactation, the poorer sleep and physical activity, together with a lower social support of the woman, may lead to deficient mental health adjustment. Our data suggest that women are at higher risk of vulnerability in lactation compared to the gestation period.

Body Appreciation, Depressive Symptoms, and Self-Esteem in Pregnant and Postpartum Brazilian Women

Background

During pregnancy and the postpartum period, women experience tremendous biopsychosocial changes in a short period of time. Poor body appreciation, depressive symptoms, and low self-esteem during the perinatal period may cause negative consequences for both the mother and the infant's physiological and psychological health. The aim of this study was to analyze the differences in body appreciation, depressive symptoms, and self-esteem between the three gestational trimesters and the postpartum period.

Methods

Participants (N = 1,423 pregnant and postpartum Brazilian women), aged between 18 and 42 years old (M = 29.22; SD = ±5.72), answered questionnaires on body appreciation, depressive symptoms, and self-esteem. BMI was self-reported. Descriptive and nonparametric covariance analysis were performed, comparing women who were in the first, second, and third trimesters and the postpartum period.

Results

Body appreciation was significantly higher among women in the third trimester compared to those in the first and second trimester. However, it was lower for women in all three gestational trimesters than for those in the postpartum. There was no difference in self-esteem during pregnancy, but it was significantly lower in the postpartum group. Similarly, depressive symptoms did not vary through pregnant groups but it was significantly higher in the postpartum group.

Conclusions

The results showed that the postpartum period can be a difficult experience for women. They presented poor body appreciation and lower self-esteem and higher depressive symptoms compared to the pregnancy period. Therefore, it is necessary for public health policies to support women in this period, preserving their mental health and making this experience more positive.

Changes of health related quality of life during pregnancy based on pregnancy context: a prospective study

Background

The significance of planned pregnancy is an accepted principle for improving the health of pregnant women; and quality of life, as one of the important indicators of women’s health, is reduced in high-risk pregnancies. The aim of this research was to investigate the changes in the health related quality of life (HRQL) in low risk pregnancies in different groups based on pregnancy context.

Methods

The present study was a prospective study conducted on 250 pregnant women divided into three groups of women with planned pregnancy, unplanned/wanted pregnancy and unwanted pregnancy. Then, using WHOQOL-26 questionnaire, the quality of life of these women was measured in physical, psychological, social and environmental dimensions at the beginning of pregnancy as well as at the end of the first, second and third trimesters.

Results

Based on the results, the mean score of environmental-HRQL in women with unwanted pregnancy was significantly lower than the other two groups. All dimensions on HRQL were influenced by time and group. However, changes in the physical, psychological and social dimensions of HRQL varied within the groups. Physical- HRQL changes were different within the groups. The intergroup effect on environmental dimension of quality of life changes was significant.

Conclusions

It was observed in this study that HRQL in the women with unwanted pregnancy was lower than the women with planned pregnancy and those with unplanned /wanted pregnancy. Moreover, increase in gestational age would lower quality of life, but this decline had a similar pattern in different groups.

The ICECAP-A instrument for capabilities: assessment of construct validity and test-retest reliability in a general Dutch population

PURPOSE

The ICEpop CAPability measure for Adults (ICECAP-A) assesses five capabilities that are important to one's well-being. The instrument might be an important addition to generic health questionnaires when evaluating quality of life extending beyond health. This study aimed to conduct a psychometric assessment of the Dutch translation of the ICECAP-A.

METHODS

Construct validity of the instrument was assessed in two ways. First, by measuring correlations with the EQ-5D-5L questionnaire and a measure of self-efficacy and, second, by investigating the ability to distinguish between groups known to differ on the construct the ICECAP-A means to capture. Additionally, test-retest reliability was evaluated.

RESULTS

In total, 1002 participants representative of the general Dutch population completed an online survey. For test-retest reliability, 252 participants completed the same questionnaire 2 weeks later. The ICECAP-A indicated moderate to strong correlations with the EQ-5D-5L and a strong correlation with self-efficacy. Furthermore, it was capable of differentiating known groups. Moreover, results indicated adequate test-retest reliability with an intraclass correlation coefficient of 0.79.

CONCLUSION

In summary, results suggest adequate test-retest reliability and construct validity and indicate that the ICECAP-A might be of added value, especially when considering areas outside of the traditional health intervention model.