A Systematic Review of Quality of Life Measures in Pregnant and Postpartum Mothers

Abstract

Quality of life has emerged as an essential health component that broadens the traditionally narrow concerns focused on only morbidity and life expectancy. Although a growing number of tools to measure quality of life are in circulation, there is a lack of guidelines as well as rigorous assessment for their use with pregnant and postpartum populations. It is also unclear whether these instruments could validly be employed to measure patient-reported outcomes in comparative effectiveness research of maternal care interventions. This paper reviews articles cited in CINAHL, COCHRANE, EMBASE, PSYCINFO, and PUBMED that addressed quality of life in pregnant and postpartum populations. Instruments used to measure quality of life in selected articles were assessed for their adherence to international guidelines for health outcomes instrument development and validation. The authors identified 129 articles that addressed quality of life in pregnant and/or postpartum women. Out of these, only 64 quality (generic and specific) scales were judged relevant to be included in this study. Analysis of measurement scales used in the pregnant and/or postpartum populations revealed important validity, reliability and psychometric inadequacies that negate their use in comparative effectiveness analysis in pregnant and post-partum populations. Valid, reliable, and responsive instruments to measure patient-reported outcomes in pregnant and postpartum populations are lacking. To demonstrate the effectiveness of various treatment and prevention programs, future research to develop and validate a robust and responsive quality of life measurement scale in pregnant and postpartum populations is needed.

Assessment Scales, Associated Factors and the Quality of Life Score in Pregnant Women in Iran

“…Despite their confirmed validity, these tools may not be appropriate for this purpose, since they are extensive assessment tools that have been designed to cover the most common areas of quality of life in the majority of the population. The problem with these general tools is that they neglect the dimensions that are relevant to specific groups of people, such as pregnant women, and therefore, fail to identify major post-treatment or post-intervention clinical changes (Mogos, August, Salinas-Miranda, Sultan, & Salihu, 2013).…”

A multicentre, randomised controlled trial of position during the late stages of labour in nulliparous women with an epidural: clinical effectiveness and an economic evaluation (BUMPES)

“…61 Collecting quality-of-life information during late pregnancy and in the early postnatal period to use in costeffectiveness analysis is controversial, because there is limited evidence about the validity of recommended instruments such as the EQ-5D-3L in this context. 62,63 However, it would be possible to estimate QALYs in the BUMPES study using a modelling exercise that synthesises available quality-of-life information during late pregnancy and in the early postpartum period from a literature review with the collected EQ-5D-3L data at 12-month follow-up. Such analysis is of interest to the research team and will be explored in future research.…”

The use of validated outcome measures in the chiropractic care of pregnant patients: A systematic review of the literature

“…However, we cannot state with certainty that the constructs informing the development of the other questionnaires (i.e., BDQ, QDQ, MYMOP2 and PROMIS) have been examined for similar meaning and appropriateness in the pregnant population. In a recent review of the literature on the use of measures to assess quality of life in pregnant and/or postpartum populations, Mogos et al [36] raised the issue on the appropriateness of generic instruments that measure health-related quality of life in diverse patient populations. While such instruments may be reliable, they may be inappropriate for special populations such as in pregnant and/or postpartum women.…”