Medical and Dental Consultantsí Association of Nigeria
Home - About us - Editorial board - Search - Ahead of print - Current issue - Archives - Submit article - Instructions - Subscribe - Advertise - Contacts - Login 
  Users Online: 1787   Home Print this page Email this page Small font sizeDefault font sizeIncrease font size
 

  Table of Contents 
ORIGINAL ARTICLE
Year : 2020  |  Volume : 23  |  Issue : 3  |  Page : 416-424

Determinants of quality of life among pregnant women in the city centre of the Central Anatolia region of Turkey


Gyneocologic and Obstetric Nursing Department, Faculty of Nursing, Dokuz Eylul University, İzmir, Turkey

Date of Submission14-Dec-2018
Date of Acceptance09-Dec-2019
Date of Web Publication5-Mar-2020

Correspondence Address:
Dr. D Bilgic
Gyneocologic and Obstetric Nursing Department, Faculty of Nursing, Dokuz Eylul University, Izmir
Turkey
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njcp.njcp_646_18

Rights and Permissions
   Abstract 


Background: To evaluate the quality of life in pregnancy is very important because of the changes in the female body during pregnancy. Quality of life should be evaluated in terms of health protection during pregnancy, prevention of health problems and treatment. Aims: The aim of this study is to determine the quality of life and the affecting factors by trimesters of pregnancy. Methods: The population of this cross-sectional study consisted of pregnant women in a city center of the Central Anatolia region of Turkey. The study included 12 districts across a range of socioeconomic structures. Every district was selected by a simple random sampling method. The study was conducted by the researchers in the home of pregnant women by face to face interview method. The data were collected using “Personal Information Form” and “Quality of Life Scale”. The total sample consisted of 1010 pregnant women, 192 of which were in first trimester, 277 of which were in second trimester and 541 of which were in third trimester. Data were analyzed using Statistical Package for Social Sciences (SPSS). Results: There was no statistically significant difference between trimesters in physical domain (P = 0.96), mental domain (P = 0.94) and social domain (P = 0.47) of quality of life scale and there was a difference only in environmental domain (P = 0.02). The lowest quality of life in all three trimesters was found to be in physical domain. Conclusion: There was no statistically significant difference between trimesters in physical, mental and social domains of quality of life scale and there was a difference only in environmental domain. The lowest quality of life scores in all three trimesters were in the physical domain. The quality of life of pregnant women differed according to the trimesters and some sub-dimensions of quality of life of pregnant women were negatively affected in all three timester.

Keywords: Affecting factors, midwife, pregnancy, quality of life


How to cite this article:
Daglar G, Bilgic D, Ozkan S A. Determinants of quality of life among pregnant women in the city centre of the Central Anatolia region of Turkey. Niger J Clin Pract 2020;23:416-24

How to cite this URL:
Daglar G, Bilgic D, Ozkan S A. Determinants of quality of life among pregnant women in the city centre of the Central Anatolia region of Turkey. Niger J Clin Pract [serial online] 2020 [cited 2020 Apr 6];23:416-24. Available from: http://www.njcponline.com/text.asp?2020/23/3/416/280039




   Introduction Top


Although pregnancy is a physiological phenomenon, it is a period of life requiring serious bio-psycho-social adjustment for women and family.[1] Physical limitations of pregnancy, systemic and hormonal changes cause different problems in pregnant women according to trimesters. Pregnant women also experience anxieties about the health of baby and fear of childbirth. It is possible to evaluate the quality of life with the tools developed to evaluate the quality of life. To evaluate the quality of life in pregnancy is very important because of the changes in the female body during pregnancy.[2] As Quality of Life (QOL) is an important outcome in evaluating burden of disease, it is important to assess quality of life in determining the burden of pregnancy-related complications, effectiveness of treatments and preventive measures.[3] In studies evaluating the quality of life in pregnancy, it was found that pregnancy might cause a decrease in the quality of life in women,[4],[5] that the quality of life in the second trimester pregnant women was the lowest in the emotional domain[6] and that pregnant women had weaker mental health in 30-32 of gestational weeks.[7]

Concept of quality of life has been increasingly used by researchers in recent years, especially in the field of health services. Assessing and measuring quality of life provide important information about the health conditions of different populations.[8] QOL should be evaluated in terms of health protection during pregnancy, prevention of health problems and treatment.[9]

Although quality of life approaches have been shown to be different in different countries and people, there is little data to reflect changes in perceived quality of life and dynamic profile during pregnancy. The following comprehensive measures require an in-topic comparison with persuasive tests to examine trend changes in the three stages of pregnancy: physical component, mental component and each health-related QOL area. In addition, no personal characteristics including sociodemographic and obstetric factors that could affect health-related quality of life during pregnancy were identified.[10]

However, the quality of life of women during pregnancy is not well understood. Many studies investigating quality of life in pregnant women focus exclusively on certain diseases such as diabetes mellitus, hypertension and depression in pregnancy, and do not overlook the daily socioeconomic factors affecting quality of life in the general pregnant population.[2] It is important that health professionals, especially midwives, take care of pregnant women when determining factors that affect the quality of life. Prenatal follow-up is suitable for assessing the quality of life of pregnant women and making necessary interventions.[11] Accordingly, the aim of this study was to determine the quality of life and the affecting factors in pregnant women with trimesters.


   Methods Top


This cross-sectional population-based study was conducted in a city center of Turkey's Central Anatolia Region. The population of this study consisted of pregnant women living in a city center 20% of the 62 quarters in the city center were aimed to be sampled. A total of different socioeconomic structures 12 quarters were selected by simple random sampling method from 4 for each quarter. A sampling frame was worked out by making a list of all quarters of city. In the first stage, 12 quarters (as clusters) were randomly chosen from 62 quarters. After the first initially selected quarter, every subsequent fifth quarter was selected (i.e. 1st, 6th, and 11th). Medical records of primary health care centers were used to determine the total pregnant woman population of these quarters at the beginning of the study.

In this study, alpha = 0.05, beta = 0.20, 1-beta = 0.80 was taken. The study was decided to have 1010 pregnant women between 1 March and 1 June 2016. The power of the test was P = 0.80930. The study was conducted between March 1 and June 1, 2016 with pregnant women who met the sampling criteria.

The study was approved by the Ethical Committee for Non-Interventional Clinical Research (ethics decision no: 2016-03/42) in the province where the study was conducted. The study was conducted in accordance with the Principles of Helsinki Declaration.

The data were collected by “Pregnant Diagnosis Form” and “The World Health Organization Quality of Life Scale” in order to determine the QOL of pregnant women.

Personal Information Form

Which was created by the researchers after the literature review was composed of 18 questions about socio-demographic and obstetric characteristics of pregnant women. Expert opinion has been taken on this form [Appendix].

The World Health Organization Quality of Life Scale (WHOQOL-BREF)

The WHOQOL-BREF is an abridged and practical form of the WHOQOL-100 which tests 4 domains: domain 1, physical health; domain 2, psychological; domain 3, social relationships; and domain 4, environment.[12] The four domain scores denote an individual' perception on quality of life in each particular domain. It is an international, cross-cultural, and generic quality of life instrument that provides a comparison of different disease conditions and not necessarily specific to any disease or intervention. This scale consists of 26 items and has a five-point rating system. It is evaluated as: very bad (1), slightly bad (2), neither good nor bad (3), quite good (4) and very good (5). Possible obtainable scores from the subscale range from 0 to 20. Scores are graded in a positive linear direction with higher scores denoting higher quality of life. As the scores increase, so does the quality of life. In this study, the cronbach alpha value of the WHOQOL-BREF scale was 0.843.

The study was carried out as a home visit by the researchers and an appointment was made with women prior to the visit. In the home visit, the consent of pregnant women was obtained by reading the information in the volunteer form. “Pregnant Diagnosis Form” and “Quality of Life Scale” were filled out by the ones who accepted to participate and the interview lasted approximately 20 minutes.

Statistical evaluation of the data was undertaken using SPSS 22.0 (IBM Corp, Armonk, NY.) software for Windows. The data were analyzed using Kolmogorov Smirnov and Shapiro Wilk tests. Number, percentage, mean, standard deviation, Independent Sample T-Test and One-way ANOVA tests were used. LSD and Tukey tests were used to determine the difference groups. Statistical significance was accepted as P < 0.05.


   Results Top


The average age of all pregnant women (n = 1010) was 27.4 (6) (min 17-max 44) and 81.3% of the pregnant women were in the 20-34 age group. It was found that 49.3% of the pregnant women were primary school graduates, 57.6% were married for 5 years, 81.1% did not work in any kind of jobs, 74.0% had a nuclear family type, 89.8% did not have chronic disease, 73.9% stated their economic status as “balanced income and expenditures”.

[Figure 1] shows the average of quality of life sub-areas according to trimesters. When physical domain (PD), mental domain (MD), social domain (SD) and environmental domain (ED) scores of first trimester pregnant women in the study were examined, their mean scores were found 14.1 (2.5), 14.7 (2.1), 14.9 (2.8), and 14.7 (2.0), respectively. When PD, MD, SD and ED scores of second trimester pregnant women in the study were examined, their mean scores were found 14 (2.8), 14.7 (2.3), 14.6 (2.9) and 14.7 (2.2) respectively. When PD, MD, SD and ED scores of third trimester pregnant women in the study were examined, their mean scores were found 14 (2.6), 14.7 (2.3), 14.6 (2.8), and 15.1 (2.2) respectively [Figure 1]. There was no statistically significant difference between trimesters in PD (P = 0.96), MD (P = 0.94) and SD (P = 0.47) of quality of life scale and there was a difference only in ED (P = 0.02).
Figure 1: Average distribution graph of quality of life sub-areas according to trimesters

Click here to view


When the distribution of quality of life mean scores of pregnant women according to demographic and obstetric data was examined in the first trimester pregnant women, it was found that the mean scores of the PD of quality of life were significantly lower in the nulligravida women (13.3 (2.7) P < 0.01), and who had not children yet (13.6 (2.7), P = 0.02). The mean scores of quality of life in MD were found to be statistically lower in pregnant women who had chronic disease (13.7 (2.3), P = 0.03) and who had their first pregnancy (14.2 (2.3), P = 0.02). The mean scores of quality of life in ED were found to be statistically lower in pregnant women who had chronic disease (13.0 (2.3), P < 0.01), and who had their first pregnancy (13.9 (2.0), P < 0.01) [Table 1]. Of quality of life subscalea mean scores of age, educational level, duration of marriage, working status, family type, perception of income status, smoking, perception of health, number of abortion, taking of medication, health status in pregnancy, planning of pregnancy, and being ready for parental role in pregnant women were found to be similar in the first trimester.
Table 1: Distribution of quality of life mean scores of pregnant women in the first trimester according to demographic and obstretric characteristics

Click here to view


When the distribution of quality of life mean scores of pregnant women according to demographic and obstetric data was examined in the second trimester pregnant women, it was found that the mean scores of the PD were statistically significant lower in pregnant women who had health problems (13.2 (3.2), P < 0.01), and who did not take medication (13.7 (2.8), P = 0.03). It was found that the mean scores of the SD quality of life were statistically significant lower in pregnant women who had three and more pregnancies (13.8 (2.8), P < 0.01) and who had two or more children (13.8 (2.8), P = 0.02). It was found that the mean scores of ED quality of life were statistically significantly lower in pregnant women who stated that they were not ready for parental role (13.7 (3.0), P = 0.03) [Table 2]. Of quality of life subscalea mean scores of age, educational level, duration of marriage, working status, family type, perception of income status, smoking, perception of health, chronic disease, number of abortion, planning of pregnancy in pregnant women were found to be similar in the second trimester.
Table 2: Distribution of quality of life mean scores of pregnant women in the second trimester according to demographic and obstretric characteristics

Click here to view


When the distribution of QOL mean scores of pregnant women according to demographic and obstetric data was examined in the third trimester pregnant women, it was found that the mean scores of the PD were statistically significant lower in pregnant women who did not take medication (13.8 (2.8), P < 0.01), whose pregnancy was not planned (13.7 (2.7), P = 0.04) and who perceived their health poor (13.3 (2.8), P = 0.03). It was found that the mean scores of the MD quality of life were statistically significantly lower in pregnant women who did not take any medication during pregnancy (14.5 (2.4), P = 0.04), and who perceived their health status poor (14 (2.9), P = 0.02). Mean scores of the SD quality of life were statistically significantly lower in pregnant women who stated that their income was less than their expense (14.1 (3.2), P = 0.03) [Table 3]. Of quality of life subscalea, mean scores of age, educational level, duration of marriage, working status, family type, smoking, chronic disease, number of pregnancy, number of abortion, para, health problems in pregnancy, and being ready for parental role in pregnant women were found to be similar in the third trimester.
Table 3: Distribution of quality of life mean scores of pregnant women in the third trimester according to demographic and obstretric characteristics

Click here to view



   Dıscussıon Top


This study is important and noteworthy in terms of evaluating quality of life in three trimesters, conducting as home visit and reaching the results that can fill the gap in literature. Our study is of great importance in terms of having a large population consisting of 1010 pregnant women in all three trimesters ( first trimester 192, second trimester 277 and third trimester 541) and evaluating the QOL of pregnant women in physical, mental, social and environmental sub-dimensions. Furthermore, our study contributes to the literature in terms of revealing socio-demographic and obstetric variables affecting the quality of life of pregnant women in the first, second and third trimesters. Findings from our study could be important in clinical practice as some of the variables determined can be altered. Different interventions can be advanced to increase quality of life of pregnant women.

In the study, no significant difference was found between the trimesters in PD, MD and SD of quality of life, but found only in ED. The third-trimester pregnant women had significantly higher ED of quality of life scores than the first and second trimester pregnant women. Mazúchová et al.[13] found that the quality of life in the first trimester was higher than the third trimester and the lowest in the second trimester, but no significant difference was found between the trimesters. Fernandes and Vido[14] also confirmed that there was no significant differences in quality of life between trimesters.

The lowest quality of life in all three trimesters was found to be in PD in this study [Figure 1]. In other studies, it was found that the physical function and vitality of pregnant women decreased compared to pre-pregnancy and there was a decrease in quality of life even in healthy pregnancy process.[15] Ramírez-Vélez,[6] Lau and Yin[16] found low PD of quality of life in pregnant women in the second trimester. Jakubauskiene et al.[17] also found low PD of quality of life in pregnant women in the first trimester. They also found that the number of pregnancies had a negative effect on quality of life.

In the study of Singh et al.[18] conducted to determine quality of life of reproductive age women, it was found that high number of pregnancies affected the quality of life negatively and that the quality of life of women with high parity decreased in both PD and MD. In another study, the mental quality of life of multiparous women was found to be worse than nullipars.[10] QOL is much more important in pregnancy. Demographic characteristics such as age and gender, socio-economic characteristics such as education and social status, cultural characteristics and values, health factors such as functional status, health services and personality traits are the main indicators of quality of life.[19]

In our study, the number of pregnancies affected the PD, MD and ED in the first trimester [Table 1] and only the SD in the second trimester [Table 2]. Furthermore, PD quality of life of the first trimester pregnant women who had no living children [Table 1] and SD quality of life of the second trimester women who had two or more children were found to be low [Table 2]. A variety of uncertainties and concerns that may affect the quality of life of primiparous women due to the more intense experience of unknown emotions may lead to low MD and ED quality of life in the first trimester. In contrast to our study findings, multiparous pregnant women reported to have worse mental health levels than nulliparous ones,[10] the quality of life of multiparas was higher than that of primiparas, although there was no significant difference.[8] In one study, primiparas were found to have higher quality of life than multiparas.[20] Abbaszadeh et al.[15] found a significant relationship between quality of life and gestational age, gravidity and number of births in Iranian pregnant women. Alzboon ve Vural[21] determined high-parity women had lower qualty of life scores than low-parity women.

In our study, the MD and ED quality of the first trimester pregnant women with chronic disease [Table 1] and PD quality of life of the second trimester pregnant women with health problems in pregnancy were found to be low. PD quality of life of pregnant women in the second trimester [Table 2], both PD and MD quality of life pregnant women in the third trimester who took medication during pregnancy [Table 3] had low quality of life. Furthermore, the MD quality of life of the third trimester pregnant women who took medication was found to be low [Table 3]. In the qualitative study of Sawyer et al.,[22] pregnant women stated that they were constantly worried about the development of complications that might cause maternal or fetal death. Marchetti et al.[23] also found that pregnant women with health problems might have worse quality of life in the short and long term.

PD and MD quality of the third trimester pregnant women who perceived their health status poor were found to be low in our study [Table 3]. In a study conducted in Canada in accordance with the findings of our study, it was found that the PD quality of the pregnant women in the third trimester was poor.[24] In other studies, pregnancy-specific anxiety was found to have an impact on how pregnant women perceived physical quality of life,[25] anxiety in pregnancy carried a higher risk than medical conditions.[26] Wang et al.[27] reported that pregnant women who were happy with their pregnancies had a better general health perception and that poor physical and social health in the last period of pregnancy might lead to premature birth.

In our study, perception of income affected only SD quality of life in third-trimester pregnant women and pregnant women who stated that their income was less than their expense had low social quality of life [Table 3]. Ramirez-Velez[6] found that low income level was an important factor in the decrease of the quality of life of pregnant women. Bai et al.[25] predict that low income level may adversely affect the mental domain of quality of life. Abbaszadeh et al.[15] also found a significant relationship between quality of life and income level of pregnant women. In a study conducted in Turkey with third-trimester pregnant women, there was a difference in the scores of mental health and social function of the quality of life in pregnant women who had no regular income.[28]

In our study, pregnancy planning status did not affect any domain of quality of life in first and second trimester pregnant women, but only affected PD quality of life in third trimester pregnant women [Table 3]. Study results of Najafian et al.[29] and Khajehpour et al.[30] were consistent with our first and second trimester quality of life results. Women with an unplanned pregnancy or pregnancy occurring at the wrong time also had lower physical health related quality of life than women reporting pregnancies that were planned or happened at the right time.[31] In our study, low quality of life in the third trimester pregnant women may be associated with less socioeconomic resources, lack of social support, and psychosocial stress and pressure. Although there was no significant difference in the MD quality of the pregnant women with planned pregnancy in our study, it was found to be higher than those who had unplanned pregnancy. The results of a qualitative study have showed that planned pregnancy brings the happiness of pregnant women.[22] In the study of Çalıkoǧlu et al.[28] a difference was found in the scores of vitality, mental health and social function of the quality of life pregnant women who have unwanted pregnancy.

Consequently, our study showed that the quality of life of pregnant women changed according to the trimesters and different factors could affect the quality of life of pregnant women in all three trimesters. In addition, the lowest quality of life in all three trimesters was found to be in the physical domain, but the quality of life was significantly different only in the environmental domain according to trimesters. Prenatal follow-ups are suitable for evaluating the quality of life of pregnant women and performing the necessary interventions. In improving quality of life of pregnant women, midwives and nurses in family health centers have great responsibilities.

In the evaluation of the QOL of pregnant women, it is recommended to perform qualitative studies, and to perform studies in large samples in which the quality of life and the factors affecting the quality of life of each pregnant woman are determined.

Limitations

When the literature was examined, a similar study was not found in our country with the same sample size and home visits that evaluated the quality of life in pregnant women. In this respect, this study is the first study in the case of a large community in the form of a home visit. However, it can be generalized only to pregnant women in the province center of the country where the study is conducted. Also, pregnant women with communication difficulties and mental disability were not included in the sampling. Because these pregnant women may not understand the questions correctly and can not answer properly.

Acknowledgements

The authors wish to thank the pregnant women, doctor and midwives in the primary health care centers a city center of Turkey's Central Anatolia Region who cooperated with this research effort.

Author contributions

All authors participated in the conceptualization of the study and collaborated in the design. GD collected the data. SAO oversaw the data analysis. GD, DB and SAO wrote the manuscript, whereas all authors reviewed and approved the final draft. Funding was contributed to by the authors. DB is the corresponding author of the manuscript.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.


   Appendix Top



   Pregnant information form Top


Age:

Level of education:

Type of family:

Duration of marriage:

Do you work? Yes ( ) No ( )

Perception of economic situation:

Income less than expenditure ( ) Income equal expenditure ( ) Income more than expenditure ( )

Perception of health status

Very good ( ) Good ( ) Middle ( ) Bad ( ) Terrible ( )

Do you smoke? Yes ( ) No ( )

Are there any health problems? Yes ( ) No ( )

if yes, please explain:

Status of continuous drug use: Yes ( ) No ( )

if yes, please explain:

Number of pregnancy:

Para:

Number of abortus:

Number of children living number:

Pregnancy week:

Is pregnancy planned? Yes ( ) No ( )

Do you have health problems in pregnancy? Yes ( ) No ( )

if yes, please explain:

Do you feel ready for motherhood? Yes ( ) No ( )



 
   References Top

1.
Calou CGPP, Pinheiro AKB, Castro RChMB, Oliveira MFD, Aquino PDS, Antezana FJ. Health related quality of life of pregnant women and associated factors: An ıntegrative review. Health Promot Pract 2014;6:2375-87.  Back to cited text no. 1
    
2.
Morin M, Vayssiere C, Claris O, Irague F, Mallah S, Molinier L, et al. Evaluation of the quality of life of pregnant women from 2005 to 2015. Eur J Obstet Gynecol Reprod Biol 2017;214:115-30.  Back to cited text no. 2
    
3.
Agampodi SB, Wickramasinghe ND, Horton J, Agampodi TC. Minor ailments in pregnancy are not a minor concern for pregnant women: A morbidity assessment survey in rural sri lanka. PLoS One 2013;8:e64214.  Back to cited text no. 3
    
4.
Kazemi F, Nahidi F, Kariman N. Exploring factors behind pregnant women's quality of life in Iran: A qualitative study. Electron Physician 2017;9:5991-6001.  Back to cited text no. 4
    
5.
Lagadec N, Steinecker M, Kapassi A, Magnier AM, Chastang J, Robert S, et al. Factors influencing the quality of life of pregnant women: A systematic review. BMC Pregnancy Childbirth 2018;18:455.  Back to cited text no. 5
    
6.
Ramírez-Vélez R. Pregnancy and health-related quality of life: A cross sectional study. Colomb Med 2011;42:476-81.  Back to cited text no. 6
    
7.
Gartland D, Brown S, Donath S, Perlen S. Women's health in early pregnancy: Findings from an Australian nulliparous cohort study. Aust N Z J Obstet Gynaicol 2010;50:413-8.  Back to cited text no. 7
    
8.
Ghaforifard S, Rostamineiad M, Nasrolahi A, Darabi S, Sokhtezari S. Evaluating the association between quality of life and physical activity in female student children scientific. J Ilam Univ Med Sci 2013;21:144-51.  Back to cited text no. 8
    
9.
Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, Asghari Jafarabadi M, Shiri F, Ghanbari-Homayi S. Feasibility, reliability, and validity of the Iranian version of the quality of life questionnaire for pregnancy. Iran Red Cres Med J 2016;18:e35382.  Back to cited text no. 9
    
10.
Chang SR, Chen KH, Lin MI, Lin HH, Huang LH, Lin WA. A repeated measures study of changes in health-related quality of life during pregnancy and the relationship with obstetric factors. J Adv Nurs 2014;70:2245-56.  Back to cited text no. 10
    
11.
Calou CGP, de Oliveira MF, Carvalho FHC, Soares PRAL, Bezerra RA, de Lima SKM, et al. Maternal predictors related to quality of life in pregnant women in the Northeast of Brazil. Health Qual Life Outcomes 2018;16:109.  Back to cited text no. 11
    
12.
The WHOQOL Group. The World Health Organization Quality of Life Assessment (WHOQOL): Development and general psychometric properties. Soc Sci Med 1998;46:1569-85.  Back to cited text no. 12
    
13.
Mazúchová L, Kelčíková S, Dubovická Z. Measuring women's quality of life during pregnancy. Kontakt 2018;20:e31-6.  Back to cited text no. 13
    
14.
Fernandes RAQ, Vido MB. Pregnancy and quality of life: Assessment during the gestational trimester. OBJN 2009;11:8.  Back to cited text no. 14
    
15.
Abbaszadeh F, Baghery A, Mehran N. Quality of life among pregnant women. Hayat 2009;15:41-8.  Back to cited text no. 15
    
16.
Lau Y, Yin L. Maternal, obstetric variables, perceived stress and health-related quality of life among pregnant women in Macao, China. Midwifery 2011;27:668-73.  Back to cited text no. 16
    
17.
Jakubauskiene L, Jakubauskas M, Mainelis A, Buzinskiene D, Drasutiene G, Ramasauskaite D, et al. Factors ınfluencing quality of life during the first trimester of pregnancy: A prospective cohort study. Medicina 2019;55:666.  Back to cited text no. 17
    
18.
Singh S, Kaur R, Singh S. Relationship of parity and health related quality of life among women. Human Biol Rev 2015;4:159-66.  Back to cited text no. 18
    
19.
Sováriová Soósová M. Determinants of quality of life in the elderly. Centr Eur J Nurs Midw 2016;7:484-93.  Back to cited text no. 19
    
20.
Balíková M, Bužgová R. Quality of women's life with nausea and vomiting during pregnancy. Ošetř porod asist 2014;5:29-35.  Back to cited text no. 20
    
21.
Alzboon G, Vural G. Factors influencing the quality of life of healthy pregnant women in North Jordan. Medicina 2019;55:278.  Back to cited text no. 21
    
22.
Sawyer A, Ayers S, Smith H, Sidibeh L, Nyan O, Dale J. Women's experiences of pregnancy, childbirth and the postnatal period in The Gambia: A qualitative study. Br J Health Psychol 2011;16:528-41.  Back to cited text no. 22
    
23.
Marchetti D, Carrozzino D, Fraticelli F, Fulcheri M, Vitacolonna E. Quality of life in women with gestational diabetes mellitus: A systematic review. J Diabetes Res 2017;2017:7058082.  Back to cited text no. 23
    
24.
Da Costa D, Dritsa M, Verreault N, Balaa C, Kudzman J, Khalifé S. Sleep problems and depressed mood negatively impact health-related quality of life during pregnancy. Arch Women Ment Health 2010;13:249-57.  Back to cited text no. 24
    
25.
Bai G, Raat H, Jaddoe VWV, Mautner E, Korfage IJ. Trajectories and predictors of women's health-related quality of life during pregnancy: A large longitudinal cohort study. PLoS One 2018;13:e0194999.  Back to cited text no. 25
    
26.
Guardino CM, Schetter CD. Understanding pregnancy anxiety: Concepts, correlates, and consequences. Zero to Three 2014;34:12-21.  Back to cited text no. 26
    
27.
Wang P, Liou SR, Cheng CY. Prediction of maternal quality of life on preterm birth and low birthweight: A longitudinal study. BMC Pregnancy Childbirth 2013;13:124.  Back to cited text no. 27
    
28.
Çalıkoǧlu EO, Akcay HB, Kavuncuoglu D, Tanriverdi EÇ, Yerli EB, Salca S. Socio-demographic characteristics and quality of life among women in the 3rd trimester of pregnancy living in Erzurum city center. Fam Pract Palliat Care 2018;3:33-8.  Back to cited text no. 28
    
29.
Najafian M, Cheraghi M, Mohammad Jafari R. Prevalence of and some factors relating with unwanted pregnancy in Ahwaz City, Iran 2010. ISRN Obstet Gynecol2011; Article ID 523430.  Back to cited text no. 29
    
30.
Khajehpour M, Simbar M, Jannesari S, Ramezani-Tehrani F, Majd HA. Health status of women with intended and unintended pregnancies. Public Health2013;127:58-64.  Back to cited text no. 30
    
31.
Gariepy A, Lundsberg LS, Vilardo N, Stanwood N, Yonkers K, Schwarz EB. Pregnancy context and women's health-related quality of life. Contraception 2017;95:491-9.  Back to cited text no. 31
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

Top
  
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    Abstract
   Introduction
   Methods
   Results
   Dıscussıon
   Appendix
    Pregnant informa...
    References
    Article Figures
    Article Tables

 Article Access Statistics
    Viewed120    
    Printed0    
    Emailed0    
    PDF Downloaded67    
    Comments [Add]    

Recommend this journal