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      Quality of life deterioration and associated factors in prenatal care pregnant women: assessment with the WHOQOL-BREF scale Translated title: Deterioro de la calidad de vida y factores asociados en gestantes en control prenatal: evaluación con la escala WHOQOL-BREF

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          Abstract Introduction: Quality of life is a set of situations that contribute to people's well-being. In pregnant women, it is necessary to explore the emotional, social and physical aspects. Few studies in the Latin American population explore the quality of life of pregnant women. The objective was to establish the frequency of deterioration of the physical, psychological, social and environmental quality of life and to identify the associated factors in pregnant women residing in cities of the Colombian Caribbean who attended prenatal consultation. Material and methods: A cross-sectional study was conducted on 509 pregnant women who performed daily activities and participated voluntarily and anonymously after signing informed consent. They filled out a form that explored sociodemographic and clinical characteristics and applied the WHOQOL-BREF scale, identifying the poor quality of life. Adjusted logistic regression was performed to estimate the association between quality of life (dependent variable) and biopsychosocial factors (independent variables). Results: The age of the participants was 26.8 ± 6.2 years. In 250 (49.1%) physical or mental deterioration was identified, in 281 (55.2%) deterioration of the social relationship and in 270 (53.0%) of the environmental relationship. Diabetes OR:6.01[95%CI:1.20-18.42], depression OR:4.71[95%CI:1-20-18.42], living in a rural area OR:2.96[95%CI :1.78-4.91], anguish with pregnancy OR:2.87[95%CI:1.65-5.01], financial problems OR:2.61[95%CI:1.54-4.40 ] or couple OR:2.60[95%CI:1.03-6.69], were associated with impaired quality of life (p<0.01). Being cohabiting, compared to being alone, and being a student/employee versus a housewife, were associated with a lower possibility of deterioration in quality of life (p<0.01). Conclusions: Deterioration of each quality of life domain was identified in half of the pregnant women and several biopsychosocial factors were significantly associated. Antenatal care protocols should provide guidelines for intervention on obstetric and non-obstetric factors that impair quality of life. It is necessary to highlight deficiencies in the exploration of the mental, social and environmental health of pregnant women.

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          Resumen Introducción: La calidad de vida es un conjunto de situaciones que contribuyen al bienestar de las personas. En las mujeres embarazadas es necesario explorar los aspectos emocionales, sociales y físicos. Son pocos los estudios en población latinoamericana que exploran la calidad de vida de las gestantes. El objetivo fue establecer la frecuencia de deterioro de la calidad de vida física, psicológica, social y ambiental e identificar los factores asociados en gestantes residentes en ciudades del Caribe colombiano que acudieron a consulta prenatal. Material y métodos: Se realizó un estudio transversal en 509 gestantes que realizaban actividades cotidianas y participaban de forma voluntaria y anónima previa firma del consentimiento informado. Llenaron un formulario que exploró características sociodemográficas y clínicas y aplicaron la escala WHOQOL-BREF, identificando la mala calidad de vida. Se realizó una regresión logística ajustada para estimar la asociación entre calidad de vida (variable dependiente) y factores biopsicosociales (variables independientes). Resultados: La edad de los participantes fue de 26,8 ± 6,2 años. En 250 (49,1%) se identificó deterioro físico o mental, en 281 (55,2%) deterioro de la relación social y en 270 (53,0%) de la relación ambiental. Diabetes OR:6.01[IC95%:1.20-18.42], depresión OR:4.71[IC95%:1-20-18.42], vivir en zona rural OR:2.96[IC95% :1.78-4.91], angustia con embarazo OR:2,87[IC95%:1,65-5,01], problemas financieros OR:2,61[IC95%:1,54-4,40] o pareja OR:2,60[IC95%:1,03-6,69], se asociaron con deterioro de la calidad de vida (p<0,01). Ser conviviente, comparado con estar solo, y ser estudiante/empleado versus ama de casa, se asoció con una menor posibilidad de deterioro en la calidad de vida (p<0,01). Conclusiones: Se identificó deterioro de cada dominio de la calidad de vida en la mitad de las gestantes y varios factores biopsicosociales se asociaron significativamente. Los protocolos de atención prenatal deben proporcionar pautas para la intervención sobre los factores obstétricos y no obstétricos que deterioran la calidad de vida. Es necesario resaltar las deficiencias en la exploración de la salud mental, social y ambiental de las gestantes.

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          Factors influencing the quality of life of pregnant women: a systematic review

          Background Pregnancy is a period of transition with important physical and emotional changes. Even in uncomplicated pregnancies, these changes can affect the quality of life (QOL) of pregnant women, affecting both maternal and infant health. The objectives of this study were to describe the quality of life during uncomplicated pregnancy and to assess its associated socio-demographic, physical and psychological factors in developed countries. Methods A systematic review was performed according to the PRISMA guidelines. Searches were made in PubMed, EMBASE and BDSP (Public Health Database). Two independent reviewers extracted the data. Countries with a human development index over 0.7 were selected. The quality of the articles was evaluated on the basis of the STROBE criteria. Results In total, thirty-seven articles were included. While the physical component of QOL decreased throughout pregnancy, the mental component was stable and even showed an improvement during pregnancy. Main factors associated with better QOL were mean maternal age, primiparity, early gestational age, the absence of social and economic problems, having family and friends, doing physical exercise, feeling happiness at being pregnant and being optimistic. Main factors associated with poorer QOL were medically assisted reproduction, complications before or during pregnancy, obesity, nausea and vomiting, epigastralgia, back pain, smoking during the months prior to conception, a history of alcohol dependence, sleep difficulties, stress, anxiety, depression during pregnancy and sexual or domestic violence. Conclusions Health-related quality of life refers to the subjective assessment of patients regarding the physical, mental and social dimensions of well-being. Improving the quality of life of pregnant women requires better identification of their difficulties and guidance which offers assistance whenever possible.
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            Associations between quality of life, physical activity, worry, depression and insomnia: A cross-sectional designed study in healthy pregnant women

            Health-related quality of life (QOL) is reported to be reduced during pregnancy. Associations between QOL, physical activity (PA), insomnia, depression and worry are insufficiently investigated among pregnant women. The aim of this study was to evaluate QOL and PA patterns among healthy pregnant women, and to examine how QOL might correlate to PA, sleep, worry and depression. This is an observational cross-sectional study, conducted among a convenient sample of 141 healthy pregnant women using five questionnaires: WHOQOL-brief (WHO quality of life questionnaire, brief version, ISI (Insomnia Severity Index), PSWQ (Penn State Worry Questionnaire), ZSRDS (Zung Self-Rating Depression Scale), and Pregnancy Physical Activity Questionnaire (PPAQ). Pre-gestational BMI was inversely correlated to overall health while education was positively correlated to psychological health, social relationships and environment domains. Smoking before and during pregnancy significantly impacted the general health and psychological health. Total and light PA were positively correlated to psychological health and social relationships. Sports/exercise showed positive correlations with several QOL domains. Insomnia and depression were significantly associated with a decrease in all domains of QOL, while worries were associated with a decrease in physical, psychological and environmental domains. There were significant negative correlations between ZSRDS scores and total activity. PA, worries, depression and insomnia affected QOL during pregnancy. Furthermore, pregnant women presenting depression had a reduced total PA. Sleep and mental health as well as encouraging PA during pregnancy are necessary to improve the quality of life of pregnant women.
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              Sleep problems and depressed mood negatively impact health-related quality of life during pregnancy.

              The objectives of this study were to evaluate and identify determinants of health related quality of life (HRQoL) during pregnancy. Pregnant women (n = 245) completed questionnaires measuring: HRQoL (Short Form Health Survey SF-36), life stress, social support, sleep, and depressed mood in the third trimester. Demographics and medical variables were also collected. Compared to Canadian normative data, our sample scored significantly poorer on the following HRQoL domains: physical functioning, role limitations due to physical health problems, bodily pain, vitality, and social functioning. Multivariate linear regressions were used to model each of the SF-36 subscales. Experiencing sleep problems emerged as a significant determinant of poorer HRQoL in all domains, with the exception of emotional role. Higher depressed mood scores was independently associated with lower HRQoL in six of the eight domains, including bodily pain, general health, vitality, social functioning, emotional role, and mental health. Greater pregnancy-related anxiety was independently associated with lower scores on physical functioning and role limitations due to physical health problems. Women experience lower HRQoL during pregnancy, particularly in the physical domains. The importance of identifying and managing modifiable determinants early in pregnancy to enhance maternal health status is discussed.
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                Author and article information

                Journal
                ijm
                Iberoamerican Journal of Medicine
                Iberoam J Med
                Hospital San Pedro (Logroño, La Rioja, Spain )
                2695-5075
                2695-5075
                2023
                : 5
                : 1
                : 27-35
                Affiliations
                [1] Cartagena Bolívar orgnameUniversidad de Cartagena orgdiv1Facultad de Medicina orgdiv2Grupo de Investigación Salud de la Mujer Colombia
                Article
                S2695-50752023000100004 S2695-5075(23)00500100004
                10.53986/ibjm.2023.0007
                c28efcaa-0501-41df-8488-d615b0e36f6a

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 16 January 2023
                : 13 November 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 25, Pages: 9
                Product

                SciELO Spain

                Categories
                Original Article

                Women health,Cuidado prenatal,Obstetricia,Salud maternal,Quality of life,Pregnancy,Mental health,Prenatal care,Obstetrics,Maternal health,Calidad de vida,Embarazo,Salud de la mujer,Salud mental

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