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Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Mini-Review Article

Tools for Quality of Life Assessment during Pregnancy: A Narrative Review

Author(s): Kyriaki Mitta, Gesthimani Mintziori*, George Mastorakos, Eleftheria Taousani, Maria Tzitiridou and Dimitrios G. Goulis

Volume 19, Issue 2, 2023

Published on: 22 July, 2022

Article ID: e200522205074 Pages: 8

DOI: 10.2174/1573404818666220520115655

Price: $65

Abstract

Background: Pregnancy is a period of physiological and hormonal alterations that can decrease the quality of life (QoL). Women’s subjective perception of QoL is clinically relevant for assessing the effectiveness of interventions and identifying susceptibility to depression.

Objectives: This review aims to identify, present, and critically appraise the assessment tools of QoL during pregnancy.

Methods: A narrative review of the English-language literature was conducted through the PubMed, CENTRAL, Scopus, and Google Scholar electronic databases.

Conclusion: Several generic instruments have been proposed, such as pregnancy-specific and disease- specific questionnaires concerning common diseases during pregnancy. Plasma, salivary and hair cortisol, inflammatory, genetic and epigenetic biomarkers and gut microbiome have also been investigated as potential indicators of maternal anxiety. Their use can quantify the association between pregnancy-specific anxiety and QoL. Application of validated assessment tools of QoL during pregnancy could improve QoL, maternal health interventions, and early identification of susceptibility to maternal depression.

Keywords: Quality of life, health-related quality of life, assessment tools, questionnaires, biomarkers, pregnancy.

Graphical Abstract

[1]
The World Health Organization Quality of Life assessment (WHOQOL): Position paper from the World Health Organization. Soc Sci Med 1995; 41(10): 1403-9.
[http://dx.doi.org/10.1016/0277-9536(95)00112-K] [PMID: 8560308]
[2]
Haas JS, Jackson RA, Fuentes-Afflick E, et al. Changes in the health status of women during and after pregnancy. J Gen Intern Med 2005; 20(1): 45-51.
[http://dx.doi.org/10.1111/j.1525-1497.2004.40097.x] [PMID: 15693927]
[3]
Morin M, Claris O, Dussart C, et al. Health-related quality of life during pregnancy: A repeated measures study of changes from the first trimester to birth. Acta Obstet Gynecol Scand 2019; 98(10): 1282-91.
[http://dx.doi.org/10.1111/aogs.13624] [PMID: 30985917]
[4]
Wilkie S, Crawley R, Button S, Thornton A, Ayers S. Assessing physical symptoms during the postpartum period: Reliability and validity of the primary health questionnaire somatic symptom subscale (PHQ-15). J Psychosom Obstet Gynaecol 2018; 39(1): 56-63.
[http://dx.doi.org/10.1080/0167482X.2017.1289167] [PMID: 28635532]
[5]
Slavin V, Gamble J, Creedy DK, Fenwick J, Pallant J. Measuring physical and mental health during pregnancy and postpartum in an Australian childbearing population - validation of the PROMIS Global Short Form. BMC Pregnancy Childbirth 2019; 19(1): 370.
[http://dx.doi.org/10.1186/s12884-019-2546-6] [PMID: 31640626]
[6]
Nott PN, Cutts S. Validation of the 30-item General Health Questionnaire in postpartum women. Psychol Med 1982; 12(2): 409-13.
[http://dx.doi.org/10.1017/S0033291700046742] [PMID: 7100363]
[7]
Sharp DJ. Validation of the 30-item General Health Questionnaire in early pregnancy. Psychol Med 1988; 18(2): 503-7.
[http://dx.doi.org/10.1017/S0033291700008047] [PMID: 3399597]
[8]
Vachkova E, Jezek S, Mares J, Moravcova M. The evaluation of the psychometric properties of a specific quality of life questionnaire for physiological pregnancy. Health Qual Life Outcomes 2013; 11(1): 214.
[http://dx.doi.org/10.1186/1477-7525-11-214] [PMID: 24365336]
[9]
Symon A, Downe S, Finlayson KW, Knapp R, Diggle P. The feasibility and acceptability of using the mother-generated index (MGI) as a patient reported outcome measure in a randomised controlled trial of maternity care. BMC Med Res Methodol 2015; 15(1): 100.
[http://dx.doi.org/10.1186/s12874-015-0092-0] [PMID: 26582386]
[10]
Foxcroft KF, Callaway LK, Byrne NM, Webster J. Development and validation of a pregnancy symptoms inventory. BMC Pregnancy Childbirth 2013; 13(1): 3.
[http://dx.doi.org/10.1186/1471-2393-13-3] [PMID: 23324494]
[11]
Hill PD, Aldag JC, Hekel B, Riner G, Bloomfield P. Maternal Postpartum Quality of Life Questionnaire. J Nurs Meas 2006; 14(3): 205-20.
[http://dx.doi.org/10.1891/jnm-v14i3a005] [PMID: 17278340]
[12]
Alderdice F, McNeill J, Gargan P, Perra O. Preliminary evaluation of the Well-being in Pregnancy (WiP) questionnaire. J Psychosom Obstet Gynaecol 2017; 38(2): 133-42.
[http://dx.doi.org/10.1080/0167482X.2017.1285898] [PMID: 28376697]
[13]
Barnett BE, Hanna B, Parker G. Life event scales for obstetric groups. J Psychosom Res 1983; 27(4): 313-20.
[http://dx.doi.org/10.1016/0022-3999(83)90054-5] [PMID: 6620208]
[14]
Dencker A, Taft C, Bergqvist L, Lilja H, Berg M. Childbirth Experience Questionnaire (CEQ): Development and evaluation of a multidimensional instrument. BMC Pregnancy Childbirth 2010; 10(1): 81.
[http://dx.doi.org/10.1186/1471-2393-10-81] [PMID: 21143961]
[15]
Theut SK, Pedersen FA, Zaslow MJ, Rabinovich BA. Pregnancy subsequent to perinatal loss: Parental anxiety and depression. J Am Acad Child Adolesc Psychiatry 1988; 27(3): 289-92.
[http://dx.doi.org/10.1097/00004583-198805000-00004] [PMID: 3379012]
[16]
DiPietro JA, Ghera MM, Costigan K, Hawkins M. Measuring the ups and downs of pregnancy stress. J Psychosom Obstet Gynaecol 2004; 25(3-4): 189-201.
[http://dx.doi.org/10.1080/01674820400017830] [PMID: 15715018]
[17]
Lacasse A, Bérard A. Validation of the nausea and vomiting of pregnancy specific health related quality of life questionnaire. Health Qual Life Outcomes 2008; 6(1): 32.
[http://dx.doi.org/10.1186/1477-7525-6-32] [PMID: 18471301]
[18]
Koren G, Boskovic R, Hard M, Maltepe C, Navioz Y, Einarson A. Motherisk-PUQE (pregnancy-unique quantification of emesis and nausea) scoring system for nausea and vomiting of pregnancy. Am J Obstet Gynecol 2002; 186(5): S228-31.
[19]
Power Z, Campbell M, Kilcoyne P, Kitchener H, Waterman H. The Hyperemesis Impact of Symptoms Questionnaire: Development and validation of a clinical tool. Int J Nurs Stud 2010; 47(1): 67-77.
[http://dx.doi.org/10.1016/j.ijnurstu.2009.06.012] [PMID: 19646694]
[20]
Ruiz de Viñaspre Hernández R, Tomás Aznar C, Rubio Aranda E. Validation of the Spanish version of the short forms of the Urogenital Distress Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7) in pregnant women. Gac Sanit 2011; 25(5): 379-84.
[http://dx.doi.org/10.1016/j.gaceta.2011.05.010] [PMID: 21871693]
[21]
Slavin V, Gamble J, Creedy DK, Fenwick J. Perinatal incontinence: Psychometric evaluation of the international consultation on incontinence questionnaire-urinary incontinence short form and wexner scale. Neurourol Urodyn 2019; 38(8): 2209-23.
[http://dx.doi.org/10.1002/nau.24121] [PMID: 31385364]
[22]
van de Pol G, de Leeuw JR, van Brummen HJ, Bruinse HW, Heintz AP, van der Vaart CH. The pregnancy mobility index: A mobility scale during and after pregnancy. Acta Obstet Gynecol Scand 2006; 85(7): 786-91.
[http://dx.doi.org/10.1080/00016340500456373] [PMID: 16817074]
[23]
Kozinszky Z, Dudas RB. Validation studies of the edinburgh postnatal depression scale for the antenatal period. J Affect Disord 2015; 176: 95-105.
[http://dx.doi.org/10.1016/j.jad.2015.01.044] [PMID: 25704562]
[24]
Sinesi A, Maxwell M, O’Carroll R, Cheyne H. Anxiety scales used in pregnancy: Systematic review. BJPsych Open 2019; 5(1): e5.
[http://dx.doi.org/10.1192/bjo.2018.75] [PMID: 30762504]
[25]
Green JM, Kafetsios K, Statham HE, Snowdon CM. Factor structure, validity and reliability of the cambridge worry scale in a pregnant population. J Health Psychol 2003; 8(6): 753-64.
[http://dx.doi.org/10.1177/13591053030086008] [PMID: 14670208]
[26]
Wijma K, Wijma B, Zar M. Psychometric aspects of the W-DEQ; a new questionnaire for the measurement of fear of childbirth. J Psychosom Obstet Gynaecol 1998; 19(2): 84-97.
[http://dx.doi.org/10.3109/01674829809048501] [PMID: 9638601]
[27]
Kennerley H, Gath D. Maternity blues. I. Detection and measurement by questionnaire. Br J Psychiatry 1989; 155(3): 356-62.
[http://dx.doi.org/10.1192/bjp.155.3.356] [PMID: 2611547]
[28]
Ibrahim SM, Lobel M. Conceptualization, measurement, and effects of pregnancy-specific stress: Review of research using the original and revised prenatal distress questionnaire. J Behav Med 2020; 43(1): 16-33.
[http://dx.doi.org/10.1007/s10865-019-00068-7] [PMID: 31183596]
[29]
Brunton RJ, Dryer R, Krägeloh C, Saliba A, Kohlhoff J, Medvedev O. The pregnancy-related anxiety scale: A validity examination using Rasch analysis. J Affect Disord 2018; 236: 127-35.
[http://dx.doi.org/10.1016/j.jad.2018.04.116] [PMID: 29730512]
[30]
Leach DM, Terry P. Nikevi AV. The Pregnancy Related Beliefs Questionnaire (PRBQ): An examination of the psychometric properties in perinatal samples. Clin Psychol Psychother 2018; 25(1): 152-62.
[http://dx.doi.org/10.1002/cpp.2149] [PMID: 29094777]
[31]
Sattler MC, Jaunig J, Watson ED, et al. Physical activity questionnaires for pregnancy: A systematic review of measurement properties. Sports Med 2018; 48(10): 2317-46.
[http://dx.doi.org/10.1007/s40279-018-0961-x] [PMID: 30094797]
[32]
Panuccio F, Berardi A, Marquez MA, et al. Development of the Pregnancy and Motherhood Evaluation Questionnaire (PMEQ) for evaluating and measuring the impact of physical disability on pregnancy and the management of motherhood: A pilot study. Disabil Rehabil 2020; 1-7.
[http://dx.doi.org/10.1080/09638288.2020.1802520] [PMID: 32748671]
[33]
Metz M, Junginger B, Henrich W, Baeßler K. Development and validation of a questionnaire for the assessment of pelvic floor disorders and their risk factors during pregnancy and post partum. Geburtshilfe Frauenheilkd 2017; 77(4): 358-65.
[http://dx.doi.org/10.1055/s-0043-102693] [PMID: 28552999]
[34]
Pascoe JM, Ialongo NS, Horn WF, Reinhart MA, Perradatto D. The reliability and validity of the maternal social support index. Fam Med 1988; 20(4): 271-6.
[PMID: 3203834]
[35]
Mokhlesi S, Simbar M, Ramezani Tehrani F, Kariman N, Alavi Majd H. Quality of life questionnaire for women with gestational diabetes mellitus (GDMQ-36): Development and psychometric properties. BMC Pregnancy Childbirth 2019; 19(1): 454.
[http://dx.doi.org/10.1186/s12884-019-2614-y] [PMID: 31783733]
[36]
Amaral TL, Monteiro GT. Translation and validation of the pregnancy and sexual function questionnaire (PSFQ). Rev Bras Ginecol Obstet 2014; 36(3): 131-8.
[http://dx.doi.org/10.1590/S0100-72032014000300007] [PMID: 24728317]
[37]
Kirk E, Preston C. Development and validation of the Body Understanding Measure for Pregnancy Scale (BUMPS) and its role in antenatal attachment. Psychol Assess 2019; 31(9): 1092-106.
[http://dx.doi.org/10.1037/pas0000736] [PMID: 31120297]
[38]
Seth S, Lewis AJ, Galbally M. Perinatal maternal depression and cortisol function in pregnancy and the postpartum period: A systematic literature review. BMC Pregnancy Childbirth 2016; 16(1): 124.
[http://dx.doi.org/10.1186/s12884-016-0915-y] [PMID: 27245670]
[39]
Kirschbaum C, Tietze A, Skoluda N, Dettenborn L. Hair as a retrospective calendar of cortisol production-increased cortisol incorporation into hair in the third trimester of pregnancy. Psychoneuroendocrinology 2009; 34(1): 32-7.
[http://dx.doi.org/10.1016/j.psyneuen.2008.08.024] [PMID: 18947933]
[40]
van der Voorn B, Hollanders JJ, Kieviet N, et al. Maternal stress during pregnancy is associated with decreased cortisol and cortisone levels in neonatal hair. Horm Res Paediatr 2018; 90(5): 299-307.
[http://dx.doi.org/10.1159/000495007] [PMID: 30541006]
[41]
Guglielminotti J, Dehoux M, Mentré F, et al. Assessment of salivary amylase as a stress biomarker in pregnant patients. Int J Obstet Anesth 2012; 21(1): 35-9.
[http://dx.doi.org/10.1016/j.ijoa.2011.09.008] [PMID: 22119632]
[42]
Tsubouchi H, Nakai Y, Toda M, et al. Change of salivary stress marker concentrations during pregnancy: Maternal depressive status suppress changes of those levels. J Obstet Gynaecol Res 2011; 37(8): 1004-9.
[http://dx.doi.org/10.1111/j.1447-0756.2010.01473.x] [PMID: 21463431]
[43]
Tegethoff M, Raul JS, Jamey C, Khelil MB, Ludes B, Meinlschmidt G. Dehydroepiandrosterone in nails of infants: A potential biomarker of intrauterine responses to maternal stress. Biol Psychol 2011; 87(3): 414-20.
[http://dx.doi.org/10.1016/j.biopsycho.2011.05.007] [PMID: 21645584]
[44]
Rudzik AE, Breakey A, Bribiescas RG. Oxytocin and Epstein-Barr virus: Stress biomarkers in the postpartum period among first-time mothers from São Paulo, Brazil. Am J Hum Biol 2014; 26(1): 43-50.
[http://dx.doi.org/10.1002/ajhb.22489] [PMID: 24265252]
[45]
Yan J, Liu Y, Cao L, Zheng Y, Li W, Huang G. Association between duration of folic acid supplementation during pregnancy and risk of postpartum depression. Nutrients 2017; 9(11): E1206.
[http://dx.doi.org/10.3390/nu9111206] [PMID: 29099069]
[46]
Coussons-Read ME, Okun ML, Nettles CD. Psychosocial stress increases inflammatory markers and alters cytokine production across pregnancy. Brain Behav Immun 2007; 21(3): 343-50.
[http://dx.doi.org/10.1016/j.bbi.2006.08.006] [PMID: 17029703]
[47]
Moore TA, Case AJ, Mathews TL, Epstein CM, Kaiser KL, Zimmerman MC. Interleukin-17A and chronic stress in pregnant women at 24-28 weeks gestation. Nurs Res 2019; 68(2): 167-73.
[http://dx.doi.org/10.1097/NNR.0000000000000334] [PMID: 30829924]
[48]
Elwood J, Murray E, Bell A, Sinclair M, Kernohan WG, Stockdale J. A systematic review investigating if genetic or epigenetic markers are associated with postnatal depression. J Affect Disord 2019; 253: 51-62.
[http://dx.doi.org/10.1016/j.jad.2019.04.059] [PMID: 31029013]
[49]
Rackers HS, Thomas S, Williamson K, Posey R, Kimmel MC. Emerging literature in the microbiota-brain axis and perinatal mood and anxiety disorders. Psychoneuroendocrinology 2018; 95: 86-96.
[http://dx.doi.org/10.1016/j.psyneuen.2018.05.020] [PMID: 29807325]
[50]
Zijlmans MA, Korpela K, Riksen-Walraven JM, de Vos WM, de Weerth C. Maternal prenatal stress is associated with the infant intestinal microbiota. Psychoneuroendocrinology 2015; 53: 233-45.
[http://dx.doi.org/10.1016/j.psyneuen.2015.01.006] [PMID: 25638481]

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