Trajectories and predictors of women's health-related quality of life during pregnancy: A large longitudinal cohort study.

Ali Montazeri,Guannan Bai,Ida J Korfage,Eva Mautner,Vincent W V Jaddoe,Hein Raat

doi:10.1371/journal.pone.0194999

Ali Montazeri, Guannan Bai + Show 4 more

Open Access

https://doi.org/10.1371/journal.pone.0194999

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Journal: PloS one	Publication Date: Apr 3, 2018
Citations: 41	License type: CC BY 4.0

Affiliation: Erasmus MC, Medical University of Graz

Abstract

The objective of this study was to identify distinct trajectories and their predictors of health-related quality of life (HRQOL) of women during pregnancy in a prospective mother and child cohort. Analyses were based on 3936 Dutch pregnant women in Rotterdam area, the Netherlands. Information on potential predictors was collected in early pregnancy by questionnaire. Latent Class Mixture Modelling and Multinomial Logistic Regression were applied to assess the trajectory and predictors of HRQOL during pregnancy. HRQOL was measured by SF-12 in early, mid- and late pregnancy; physical and mental component summary (PCS-12/MCS-12) scores were calculated. Four physical HRQOL trajectories were identified: a healthy trajectory (‘healthy’) in 63.3%, consistently low (‘vulnerable’) in 10.8%; a small increase (‘recovering’) in 12.8% and a large decrease (‘at risk’) in 13.1%. Three mental HRQOL trajectories were identified: a healthy trajectory (‘healthy’) in 86.1%; a large increase (‘recovering’) in 7.5%; and a large decrease (‘at risk’) in 6.4%. Compared with healthy trajectories, the likelihood of following the ‘vulnerable’ physical HRQOL trajectory rather than a healthy trajectory was increased by daily fatigue(OR: 4.82[2.76, 8.40]), pelvic pain (OR:4.76[2.91, 7.78]) and back pain (OR:5.29[3.21, 8.70]); pregnancy-specific anxiety increased the likelihood of following the ‘at risk’ mental HRQOL trajectory (OR:7.95[4.84, 13.05]). Healthy physical and mental HRQOL trajectories during pregnancy were most common. Predictors indicative of poor HRQOL trajectories included pregnancy-related symptoms and anxiety.

Highlights

Health-related quality of life (HRQOL) is a multidimensional term referring to the health aspects of quality of life, encompassing physical and occupational functions, psychological state, social interaction and somatic sensation.[1]
As indicated by the model fit indices, four latent classes of PCS-12 and three latent classes of MCS-12 were identified as the optimal numbers of latent classes by Latent Class Mixture Modelling (LCMM)
Regarding PCS-12, the first trajectory contained more than half of the women (n = 2491, 63.3%) and represented a healthy trajectory of physical HRQOL during pregnancy; the second trajectory, termed ‘recovering’, contained 505 women (12.8%) and represented an increase in physical HRQOL during pregnancy; the third trajectory (n = 516, 13.1%), termed ‘at risk’, was characterised by a significant decline in physical HRQOL; the fourth trajectory (n = 424, 10.8%), termed ‘vulnerable’, Table 1

Summary

Introduction

Health-related quality of life (HRQOL) is a multidimensional term referring to the health aspects of quality of life, encompassing physical and occupational functions, psychological state, social interaction and somatic sensation.[1] Women’s HRQOL is acknowledged as a critical concept in the childbearing period.[2, 3] It provides a broad view of women’s experience during pregnancy.

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