Abstract
The World Health Organization (WHO) considers quality of life a fundamental indicator. The effect of birth on women’s long-term quality of life (QoL) has barely been studied. The purpose of this study was to determine the factors related with the pregnancy, delivery and puerperium, and assess women’s QoL after giving birth. A cross-sectional study with Spanish puerperal women was carried out; it collected data on socio-demographic variables, obstetric variables, newborn data, and several quality of life parameters. An ad hoc online questionnaire, including SF-36 (validated instrument to measure QoL), was used. Crude mean differences (MD) and adjusted mean differences (aMD) were estimated by multiple linear regression. A total of 2990 women participated whose overall QoL lowered with time until three years postpartum (p = 0.045). Caesarean section (aMD = −3.61, 95% confidence interval (CI): −5.07, −2.15), mother admitted to ICU (aMD = −4.81, 95% CI: −9.56, −2.68), newborn hospitalized (aMD = −2.10, 95% CI: −4.31, −0.13) or third/fourth degree perineal tears (aMD = −6.87 95%CI: −9.93, −3.82) were detected as risk factors that affect negatively and significantly on postpartum QoL scores. Women’s postpartum QoL worsens with time. Some determining factors negatively influence postpartum QoL: Caesarean section, a mother´s admission to an intensive care unit (ICU) or a premature newborn.
Highlights
Quality of life (QoL) is a parameter that has been defined and recently taken into account as a health indicator
2990 women participated: 59.1% (1767) had studied at university, the pregnancies of 70.7% (2113) ended normally, 78.5% (2257) had a normal vaginal birth, for 63.6% (1901) no episiotomy was involved, 70.6% (2741) breastfed their infants and 66.5% (1987) of the studied cases had spent more than one year during the intergenesic period, as Table 1 shows with its study population characteristics
Episiotomy No Yes Third/fourth degree perineal tears No Yes Mother admitted to an intensive care unit (ICU) No Yes Performing postpartum surgery No Yes Readmitted to hospital after discharge No Yes Premature newborn No Yes Newborn hospitalised No Yes Formula-fed No Yes Time since last giving birth Less than 1 year 1–3 years More than 3 years n (%)
Summary
Quality of life (QoL) is a parameter that has been defined and recently taken into account as a health indicator. Different aspects of the pregnancy, birth and postpartum process and QoL have been studied [10,11,12,13,14,15,16] but, as a literature review of 75 studies indicates, very few research works have evaluated QoL during pregnancy [14]. This research related birth with the QoL score and some of its dimensions. Some of those worsened, such as their former health status, how they generally perceived their health, their disease resistance and their health concerns [11]. For the 190 Japanese women who participated in a study into QoL during pregnancy, the subscale scores for “physical function”, “physical role” and “bodily pain” significantly decreased throughout pregnancy, while no significant changes during pregnancy were noted for the “general health” and “mental health” subscales [15]
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