The factors affecting the quality of life among women during the postpartum period

Abstract

Objective: As healthcare has become increasingly patient-centered, outcomes such as disease-specific quality of life (QoL) have become increasingly important. This study aimed to determine the factors affecting the QoL of postpartum women and which factors make a difference and affect the QoL. Patients and Methods: A total of 175 postpartum mothers participated in this study. The Euro QoL 5 Dimension 5 Level (EQ 5D-5L) scale was used to measure the health-related QoL of postpartum women. Results: The QoL of women differed in age, delivery type, venous thromboembolism risk factors, parity, gravida, number of live births, and use of anticoagulant medication. According to multiple regression analyses, the “age” variable had a significant effect on the QoL. However, the variables of education, social security, employment status, and monthly income of the family were not significant determinants of QoL. Also, the “number of live births” variable did not significantly affect the QoL, other obstetric and clinical variables had a significant effect on the QoL. The gravida increased the QoL but the number of miscarriages and the venous thromboembolism risk score decreased the QoL. Conclusions: This study shows that, the QoL of women varies according to obstetric, socio-demographic, and clinical factors, and “age, gravida, the number of abortions and the venous thromboembolism risk score” variables have a significant effect on the QoL.

Keywords

• Quality of Life (QoL)
• Pregnancy
• Postpartum period
• Pregnant women
• EQ-5D-5L

References

1. [1] Van der Woude DA, Pijnenborg JM, de Vries J. Health status and quality of life in postpartum women: a systematic review of associated factors. Eur J Obstet Gynecol Reprod Biol 2015; 185:45-2. doi: 10.1016/j.ejogrb.2014.11.041
2. [2] The World Counts. How many babies are born each day? Available at: https://www.theworldcounts.com/stories/howmany- babies-are-born-each-day Accessed on 04 October 2021.
3. [3] Güneri SE. Evidence based practices in early postpartum period. Gumushane Univ J Health Sci 2015; 4:482-6.
4. [4] Çevik A, Alan S. Traditional practices applied in Pospartum Periodr Mersin University School of Medicine Lokman Hekim Journal of History of Medicine and Folk Medicine 2020; 10:14- 2. doi: 10.31020/mutftd.624508.
5. [5] World Health Organization. Postpartum care of the mother and newborn: a practical guide: report of a technical working group (No. WHO/RHT/MSM/98.3). World Health Organization; 1998.
6. [6] Cheng CY, Li, Q. Integrative review of research on general health status and prevalence of common physical health conditions of women after childbirth. Womens Health Issues 2008; 18:267-80. doi: 10.1016/j.whi.2008.02.004.
7. [7] Boybay Koyuncu S, Duman, M. Body dissatisfaction of women during postpartum period and copin strategies. Women & Health 2022; 62: 46-54. Doi:10.1080/03630.242.2021.2014019.
8. [8] Zainur RZ, Loh KY. Postpartum morbidity-what we can do. Med J Malaysia 2006; 61: 651-57.

9. [9] Hammoudeh W, Mataria A, Wick, L, et al. In search of health: quality of life among postpartum Palestinian women. Expert Rev Pharmacoecon Outcomes Res 2009; 9: 123-32.
10. [10] Van Beukering MDM. Work during pregnancy and postpartum period:research on sick leave. TBV 2002; 10: 2-7.
11. [11] Nikpour M, Abedian Z, Mokhber N, et al. Comparison of quality of life in women after vaginal delivery and cesarean section. J Babol Univ Medical Sci 2011; 13: 44-50.
12. [12] World Health Organization. Reshaping health systems towards health outcomes: report on a WHO meeting, Celle, Germany 17-19 December 1997 (No. EUR/ICP/POLC 02 02 04 (A)). Copenhagen: WHO Regional Office for Europe; 1999.
13. [13] The World Development Report. World development report 1993-Investing in Health. Commun Dis Rep CDR Wkly 1993; 3 (30):137. https://pubmed.ncbi.nlm.nih.gov/7693199/. Accessed 26 September 2021.
14. [14] Higginson IJ, Carr AJ. Using quality of life measures in the clinical setting. BMJ 2001; 322: 1297-300. doi: 10.1136/ bmj.322.7297.1297.
15. [15] The EuroQOL Group. EUROQOL instruments. Available at: https://euroqol.org/eq-5d-instruments/eq-5d-5l-about/ Accessed 26 April 2022.
16. [16] van Reenen M, Janssen B. EQ-5D-5L user guide: basic information on how to use the EQ-5D-5L instrument. Version 2.1. EuroQol Research Foundation; 2015.
17. [17] Huang W, Yang J, Liu Y, et al. Assessing health-related quality of life of patients with colorectal cancer using EQ-5D-5L: a cross-sectional study in Heilongjiang of China. BMJ Open 2018; 8: e022711.
18. [18] Poder TG, Wang L, Carrier N. EQ-5D-5L and SF-6Dv2 utility scores in people living with chronic low back pain: a survey from Quebec. BMJ Open 2020; 10: e035722.
19. [19] Poder TG, Carrier N. Predicting EQ-5D-5L utility scores from the Oswestry Disability Index and Roland-Morris Disability Questionnaire for low back pain. J Pain Res 2020; 13: 623.
20. [20] Pérez-Maná L, Cardona G, Pardo-Cladellas Y, et al. Validation of the spanish version of the low vision quality of life questionnaire. J Optom 2021:1-11.
21. [21] Akarsu G, Bayrakdar A, Karaman M, Zorba E, Yaman M, Yıldırım Y. HEALTH status of women exercising regularly according to EQ-5D-5L. Journal of Sport for All and Recreation 2019; 1: 11-9.
22. [22] Özyılmaz E, Kuşçu ÖÖ, Karakoç E, et al. Worse pre-admission quality of life is a strong predictor of mortality in critically ill patients. Turk J Phys Med Rehab 2022; 68:19-9.
23. [23] Saygılı, M. An evaluation of three different palliative care service models in terms of patients with cancer diagnosis-their family caregivers and cost-effectiveness analysis, PhD Thesis, Hacettepe University Institute of Social Sciences, Department of Health Management, Ankara; 2016.
24. [24] Tugay Yangı, D. Evaluation of cost effectiveness of standard combined therapy and supplemental combined treatment use of omalizumab in asthmatic patients adults in four different hospitals in Ankara. PhD Thesis, Hacettepe University Institute of Social Sciences, Department of Health Management, Ankara; 2022.
25. [25] Akın B, Ege E, Koçoglu D, Demirören N, Yılmaz S. Quality of life and related factors in women, aged 15–49 in the 12‐month post‐partum period in Turkey. J Obstet Gynaecol Res 2009; 35: 86-3. doi: 10.1111/j.1447-0756.2008.00870.x.
26. [26] Prick BW, Bijlenga D, Jansen AG, et al. Determinants of healthrelated quality of life in the postpartum period after obstetric complications. Eur J Obstet Gynecol Reprod Biol 2015; 185: 88-5. doi: 10.1016/j.ejogrb.2014.11.038.
27. [27] Mousavi, SA, Mortazavi F, Chaman, R, et al. Quality of life after cesarean and vaginal delivery. Oman Med J 2013; 28: 245. doi: 10.5001/omj.2013.70.
28. [28] Symon A. A review of mothers’ prenatal and postnatal quality of life. Health Qual Life Outcomes 2003; 1: 1-8. doi: 10.1186/1477-7525-1-38.
29. [29] Villar J, Carroli G, Zavaleta N, et al. Maternal and neonatal individual risks and benefits associated with caesarean delivery: multicentre prospective study. BMJ 2007; 335: 1025. doi: 10.1136/bmj.39363.706956.55.
30. [30] Torkan B, Parsay S, Lamyian M, et al. Postnatal quality of life in women after normal vaginal delivery and caesareansection. BMC Pregnancy Childbirth 2009; 9: 1-7. doi: 10.1186/1471-2393-9-4.
31. [31] Abedian Z, Nikpour M, Mokhber N, et al. Evaluation of relationship between delivery mode and postpartum quality of life. Iranian J Obstet Gynecol Infertility 2010; 13: 47-3.
32. [32] Park S, Choi NK. The relationships between timing of first childbirth, parity, and health-related quality of life. Qual Life Res 2018; 27: 937-3. doi: 10.1007/s11136.017.1770-7.
33. [33] Li WY, Liabsuetrakul T, Stray-Pedersen, B, et al. The effects of mode of delivery and time since birth on chronic pelvic pain and health-related quality of life. Int J Gynecol Obstet 2014; 124: 139-2. doi: 10.1016/j.ijgo.2013.07.029.
34. [34] Carlander AKK, Andolf E, Edman G, et al. Health-related quality of life five years after birth of the first child. Sex Reprod Health 2015; 6: 101-7. doi: 10.1016/j.srhc.2015.01.005.
35. [35] Dehcheshmeh FS, Salehian T, Parvin N. The effect of spouses’ educational classes held for primiparous women referring to Hajar hospital on their quality of life and pregnancy outcomes. Iran Nurs Midwifery Res 2014; 19: S59-S3.
36. [36] Fatemeh A, Azam B, Nahid M. Quality of life in pregnant women results of a study from Kashan, Iran. Pak J Med Sci 2010; 26 :692-7.
37. [37] Pawluski JL, Galea LAM. Reproductive experience alters hippocampal neurogenesis during the postpartum period in the dam. Neuroscience 2007; 149: 53-7. doi: 10.1016/j. neuroscience.2007.07.031.
38. [38] Şanlı Y, Öncel S. Evaluation of the functional status of woman after childbirth and effective factors. J Turk Soc Obstet Gynecol 2014; 2:105-14.
39. [39] Blondon M. Thromboprophylaxis after cesarean section: decision analysis. Thromb Res 2011; 127: S9-S2. doi: 10.1016/ S0049-3848(11)70004-4.
40. [40] Bain E, Wilson A, Tooher R et al. Prophylaxis for venous thromboembolic disease in pregnancy and the early postnatal period. Cochrane Database Syst Rev 2014; 2: 1-75. doi: 10.1002/14651858.CD001689.pub3.
41. [41] Péret FJA, de Paula LB. VTE prophylaxis in cesarean section. Current Topics in Caesarean Section, IntechOpen; 2021, 55.
42. [42] De Oliveira MF, Parker L, Ahn H, et al. Maternal predictors for quality of life during the postpartum in Brazilian mothers. Health 2015; 7: 371. doi: 10.4236/health.2015.73042.
43. [43] Calou CGP, de Oliveira MF, Carvalho FHC, et al. Maternal predictors related to quality of life in pregnant women in the Northeast of Brazil. Health Qual Life Outcomes 2018; 16: 1-10. doi: 10.1186/s12955.018.0917-8.
44. [44] Da Costa, D, Dritsa M, Rippen, N, et al. Health-related quality of life in postpartum depressed women. Arch Womens Ment Health 2006; 9: 95-2 doi: 10.1007/s00737.005.0108-6.
45. [45] Küçükkaya B, Dindar İ, Erçel Ö, et al. Anxieties of pregnant women related to delivery and postpartum period during gestational periods. JAREN 2018; 4: 28-6. doi: 10.5222/ jaren.2018.028.
46. [46] Erickson RM, Feehan M, Munger MA, et al. Understanding factors associated with quality of life in patients with venous thromboembolism. Thromb Haemost 2019; 119: 1869-6.