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

Eva Mautner,Guannan Bai,Hein Raat,Ida J Korfage

doi:10.3390/ijerph16214243

Abstract

The objective of this study was to assess associations between maternal health-related quality of life (HRQoL) in early, mid-, and late pregnancy and birth outcomes and to assess the differences in birth outcomes between subgroups of mothers reporting relatively “low” and relatively “high” HRQoL. HRQoL was measured by the 12-item Short Form Health Survey in early (n = 6334), mid- (n = 6204), and late pregnancy (n = 6048) in a population-based mother and child cohort; Physical and Mental Component Summary (PCS/MCS) scores were calculated. Birth outcomes included pregnancy duration, preterm birth, birth weight, low birth weight, and small for gestational age. We defined very high PCS/MCS scores as the >90th percentile and very low score as the <10th percentile. The lower PCS score in late pregnancy was significantly associated with a higher chance of having small-for-gestational-age birth (per 10 points: OR = 1.20, 95% CI: 1.08, 1.33, p value = 0.0006). In early, mid-, and late pregnancy, the subgroup mothers with a low MCS score had infants with a lower average birth weight than those with very high scores (p < 0.05). The association between higher physical HRQoL in late pregnancy and a higher chance of having small-for-gestational-age birth needs further research. The role of mother’s mental HRQoL during pregnancy and the potential consequences for the child require further study.

Highlights

Preterm birth, small-for-gestational-age birth, and low birth weight are relevant indicators for new-born mortality and morbidity [1,2,3]
In the whole Generation R study sample, our findings did not confirm the hypotheses that worse mental health-related quality of life (HRQoL) in early, mid, and late pregnancy is associated with more preterm birth, shorter gestational duration, lower birth weight, and more often small-for-gestational-age birth
We found a higher incidence of having a small-for-gestational-age birth in the subgroup of women who reported relatively low mental HRQoL in early, mid, and late pregnancy compared with the subgroup who reported relatively high mental HRQoL

Summary

Introduction

Small-for-gestational-age birth, and low birth weight are relevant indicators for new-born mortality and morbidity [1,2,3]. Health impairments due to these adverse birth outcomes may last until adulthood [3,4]. Maternal health factors are associated with adverse birth outcomes; examples are maternal lifestyle-related factors (e.g., tobacco/alcohol use and body mass index) and medical conditions during pregnancy (e.g., preeclampsia, diabetes, and depression) [5,6]. It is plausible that indicators of the overall maternal health during pregnancy, for example, health-related quality of life (HRQoL), may be associated with birth outcomes. HRQoL is a measure of the personal perception of the quality and value of life in the context of impairments, functional states, and opportunities as influenced by disease, injury, treatment, and policy [7]. In the adult population, a relatively low level of HRQoL has

Objectives

Methods

Results

Discussion

Conclusion