Associations between Maternal Health-Related Quality of Life during Pregnancy and Birth Outcomes: The Generation R Study

Associations of offspring birthweight and placental weight with subsequent parental coronary heart disease: survival regression using the walker cohort

Low birth weight (BW) is consistently correlated with increased parental risk of subsequent cardiovascular disease, but the links with offspring placental weight (PW) are mostly unexplored. We have investigated the associations between parental coronary heart disease (CHD) and offspring BW and PW using the Walker cohort, a collection of 48,000 birth records from Dundee, Scotland, from the 1950s and 1960s. We linked the medical history of 13,866 mothers and 8,092 fathers to their offspring's records and performed Cox survival analyses modelling maternal and paternal CHD risk by their offspring's BW, PW, and the ratio between both measurements. We identified negative associations between offspring BW and both maternal (hazard ratio [HR]: 0.91, 95% confidence interval [CI]: 0.88-0.95) and paternal (HR: 0.96, 95% CI: 0.93-1.00) CHD risk, the stronger maternal correlation being consistent with previous reports. Offspring PW to BW ratio was positively associated with maternal CHD risk (HR: 1.14, 95% CI: 1.08-1.21), but the associations with paternal CHD were not significant. These analyses provide additional evidence for intergenerational associations between early growth and parental disease, identifying directionally opposed correlations of maternal CHD with offspring BW and PW, and highlight the importance of the placenta as a determinant of early development and adult disease.

Maternal socioeconomic and lifestyle factors and life dissatisfaction associated with a small for gestational age infant. The Survey of Neonates in Pomerania (SNiP)

PURPOSE

The aim is to investigate the associations of the mother's socioeconomic and lifestyle factors and life satisfaction with the delivery of a small for gestational age (SGA) infant.

METHODS

Data from 4598 participants of the population-based birth cohort study Survey of Neonates in Pomerania (SniP) including comprehensive information on pregnancies, mothers, and their offspring in Western Pomerania, Germany were used in this study. The associations were analyzed using linear and logistic regression models.

RESULTS

After logistic regression analysis adjusted for height of the mother, women who delivered SGA infants, had lower education (p < 0.01) and smoked more frequently during pregnancy (p < 0.01) compared with mothers of adequate for gestational age (AGA) neonates. A mother with less than 10 years of education and one who continued smoking during pregnancy had an odds ratio (OR) of 2.23 [95% confidence interval (CI) = 1.44 to 3.46] and 2.68 (95% CI = 2.06-3.49) of having an SGA infant, respectively. There was no association between the employment of the mother (p = 0.28), the monthly income (p = 0.09), the family status (p = 0.80), the number of friendships outside the household that the mother would not wish to relinquish (p = 0.47), the number of people that she could rely on in case of an emergency (p = 0.75), or alcohol consumption prior to (p = 0.14) or during the pregnancy (p = 0.99) with SGA. Finally, women who delivered SGA infants were more frequently dissatisfied with their employment (p = 0.03) and financial status (p < 0.01).

CONCLUSIONS

Women who delivered SGA infants had more associated socioeconomic and lifestyle risk factors and were more frequently dissatisfied with their life conditions than mothers of AGA neonates.

Acceptance of Pregnancy-Induced Disease and Intrapersonal Resistance Resources of Pregnant Women-Preliminary Report

The health problems complicating pregnancy are a source of anxiety and concern about the developing fetus' health and life. The aim of the study was to assess the acceptance of illness and selected intrapersonal resistance resources for women whose pregnancies are complicated by gestational diabetes or pregnancy-induced hypertension and their determinants. The study was conducted from April 2019 to January 2021 in 688 pregnant women who were patients of the pregnancy pathology department and gynecology-obstetrics outpatient clinics in Lublin (Poland), using a diagnostic survey method with the use of the following research tools: Acceptance Illness Scale, Generalized Self-Efficacy Scale, Multidimensional Health Locus of Control Scale, and the standardized interview questionnaire. The study group included 337 women with gestational diabetes and pregnancy-induced hypertension. The control group included 351 women with an uncomplicated course of pregnancy. The level of acceptance of illness in pregnant women with pregnancy-induced diseases is on the border between medium and high acceptance (29.36 ± 7.82). The respondents in the control group had lower levels of self-efficacy (28.47 vs. 29.62) and health locus of control in the internal dimension (24.61 vs. 26.25) (p < 0.05). Respondents with pregnancy-induced diseases are characterized by the internal dimension of locus of health control.

Health-related quality of life among postpartum women with preeclampsia, southern Ethiopia: a prospective cohort study

Background

Preeclampsia affects the health of the mother and the fetus during pregnancy and childbirth. To date, little is known about the impact of preeclampsia on postpartum health-related to quality of life (HRQoL) in the Sidama region of southern Ethiopia. This study aimed to measure the HRQoL and its contributing factors among postpartum women with preeclampsia in the Sidama region.

Methods

A prospective cohort study was conducted by enrolling pregnant women at ≥20 weeks of gestation up until the 37th week of gestation. We then followed them until 12 weeks after delivery. A locally validated, World Health Organization Quality-of-Life-BREF (WHOQOL-BREF) tool was used to assess participants’ HRQoL at two time points; the 6th and 12th weeks postpartum. Assessment of HRQoL of participants was based on total scores on the WHOQoL-BREF. Higher scores on the WHOQoL-BREF reflected a higher HRQoL. Multiple linear regression analyses were performed to evaluate the contributing factors to HRQoL. The level of significance was determined at a p-value of < 0.05.

Results

The HRQoL of postpartum women with preeclampsia significantly improved over time from 6 (151 ± 17) to 12 weeks (167 ± 18), p < 0.001). However, the overall HRQoL scores were lower (156 ± 16, p < 0.001) among women with preeclampsia compared to normotensive women (181 ± 21). An experience of early neonatal death was found to have a significant negative effect on the HRQoL of women with preeclampsia [β = − 2.1, 95% CI: − 3.43– − 0.85] compared to normotensive women who did not have early neonatal death. At 6 weeks of the postpartum period, the physical domain was found to have a significantly higher contribution to the lower HRQoL [β = 1.04, 95% CI: 0.88–1.12] compared to normotensive women, while other factors were constant.

Conclusions

The HRQoL of women with preeclampsia improved over time from 6 to 12 weeks in the postpartum period. Lower HRQoL was observed among postpartum women with preeclampsia, especially among those who experienced preterm birth or early neonatal death. The effects of preeclampsia on the HRQoL of postpartum women should be considered in redesigning postnatal care intervention services.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12955-022-02061-2.

Associations between Pregnancy-Related Symptoms, Serum 25(OH)D, and Physical Quality of Life in Pregnant Women

Vitamin D deficiency has been associated with pregnancy-related symptoms including fatigue, poor sleep quality, and musculoskeletal pain. Pregnant Black and Hispanic women are more likely to have vitamin D deficiency compared with pregnant non-Hispanic White women. Data are limited on the association of vitamin D deficiency with quality of life (QOL) among pregnant women. This study examined the association of serum 25(OH)D and pregnancy-related symptoms with QOL among pregnant predominantly minority women. Using a cross-sectional design, 119 pregnant Black and Hispanic women completed surveys and had blood drawn for serum 25(OH)D levels between 24–32 weeks gestation. Hierarchical regression analysis indicated that total pregnancy-related symptoms and serum 25(OH)D level were significant predictors of QOL, while controlling for covariates. Higher total pregnancy-related symptoms and lower serum 25(OH)D predicted poorer physical QOL. Screening for pregnancy-related symptoms and vitamin D levels among childbearing women might be important nursing interventions to improve physical QOL.

Pathways from pain to physical and mental health-related quality of life during the third trimester of pregnancy: an exploratory mediation analysis

AIMS AND OBJECTIVES

To understand how pain affects physical and mental health-related quality of life during the third trimester of pregnancy.

BACKGROUND

Poor health-related quality of life during pregnancy is associated with adverse maternal foetal health outcomes such as increased risk of low-birth-weight neonates. Poor health-related quality of life is linked to pain, pain interference and anxiety in the general adult population. However, we do not know how pain, pain interference (i.e., interference of pain with patient function), and anxiety are interrelated during the third trimester of pregnancy.

METHODS

This exploratory cross-sectional study followed STROBE guidelines. A mobile educational and tracking pregnancy application was used to obtain a racially/ethnically diverse convenience sample of 141 third trimester pregnant women from the U. S. In this sample, 58.2% of women had commercial health insurance, 68.8% were Caucasian, 86.5% were younger than 35 years, and 85.1% had a partner. Women completed demographics, Edinburgh Postnatal Depression Scale and the Brief Pain Inventory on REDCap. Path analysis was used to investigate a model for the relationships among pain intensity, pain interference, anxiety and physical and mental health-related quality of life.

RESULTS

Pain intensity affected health-related quality of life indirectly by increasing pain interference, which in turn, decreased both physical and mental health-related quality of life. In addition, pain interference also increased anxiety, which in turn worsened mental health-related quality of life, but not physical health-related quality of life.

CONCLUSIONS

Treating perinatal pain may improve health-related quality of life by decreasing pain interference and anxiety.

RELEVANCE TO CLINICAL PRACTICE

Nurses should assess for pain interference and anxiety in women experiencing moderate to severe pain during the third trimester of pregnancy. With this knowledge, nurses may advocate for women in receiving effective treatment for their conditions and improvements in their physical and mental health-related quality of life.