Impact of maternal morbidities on the longitudinal health-related quality of life trajectories among women who gave childbirth in four hospitals of Northwest Ethiopia: a group-based trajectory modelling study

Abstract

ObjectivesTo identify distinct trajectories of health-related quality of life and its predictors among postpartum women in Northwest Ethiopia.DesignHealth facility-linked community-based prospective follow-up study.SettingSouth Gondar zone, Northwest Ethiopia.ParticipantsWe recruited 775 mothers (252 exposed and 523 non-exposed) after childbirth and before discharge. Exposed and non-exposed mothers were identified based on the criteria published by the WHO Maternal Morbidity Working Group.Outcome measuresThe primary outcome measure of this study was trajectories of health-related quality of life. The Stata Traj package was used to determine the trajectories using a group-based trajectory modelling. Multinomial logistic regression model was used to identify predictors of trajectory membership.ResultsFour distinct trajectories for physical and psychological and five trajectories for the social relationships and environmental health-related quality of life were identified. Direct and indirect maternal morbidities, lower educational status, poor social support, being government employed and merchant/student in occupation, vaginal delivery, lower monthly expenditure, stress, fear of childbirth and anxiety were found to be predictors of lower health-related quality of life trajectory group membership.ConclusionsHealth professionals should target maternal morbidities and mental health problems when developing health intervention strategies to improve maternal health-related quality of life in the postpartum period. Developing encouraging strategies for social support and providing health education or counselling for women with less or no education are essential to avert the decrease in health-related quality of life trajectories of postpartum women.

Longitudinal path analysis for the directional association of depression, anxiety and posttraumatic stress disorder with their comorbidities and associated factors among postpartum women in Northwest Ethiopia: A cross-lagged autoregressive modelling study

“…The results of this study also showed a gradual reduction of comorbidities between depression, anxiety and PTSD symptoms over the 18 weeks of postpartum period. The gradual reduction in comorbidities of depression, anxiety and PTSD indicates the normal adjustments of women over time as reported by previous studies [56,57].…”

“…As part of the health facility linked community based prospective follow-up study conducted in Northwest Ethiopia to determine the effect of maternal morbidities on maternal health related quality of life, functional status and mental health problems [ 56 , 57 ], postpartum women were recruited in four hospitals of south Gondar zone, Northwest Ethiopia. The data collection took place between October 1, 2020 and March 30, 2021.…”

Health-related quality of life measured by SF-36 among postdelivery mothers attending maternal and child health clinic in Eastern Nepal: a cross-sectional study

“…However, Malaju et al . 16 reported that postpartum women who worked outside their homes had poorer HRQoL. Other studies did not find any significant association of HRQoL with different modes of delivery 17 , 18 , level of education 15 , 19 , and income level 15 , 19 .…”

“…In contrast, Malaju et al . 16 reported that women with vaginal deliveries were likelier to have a poorer HRQoL. Also, lower income was associated with poorer HRQoL after childbirth 21 , 22 .…”

“…Also, lower income was associated with poorer HRQoL after childbirth 21 , 22 . Level of education also affects the HRQoL 16 , 23 , with lower education levels in women significantly associated with a lower HRQoL 16 . In contrast, some studies have reported that higher education was significantly associated with a lower HRQoL 14 , 24 .…”