Changes in health-related quality of life measured by the RAND-12 HSI and predictive factors in the early postpartum period: A prospective observational study.

Objective

To identify the determinants of changes in health-related quality of life (HRQoL) between the immediate and 2-month postpartum periods.

Methods

This study was a secondary analysis of a multicentre prospective cohort study, conducted between 2020 and 2023 in four French maternity wards. Women who delivered singletons after 37 weeks of gestation were eligible for inclusion. The 12-item Short Form Health Survey was completed immediately and 2 months postpartum as an online self-administered questionnaire. The global health composite score (global score), physical health composite (PHC) score and mental health composite (MHC) score were calculated via the RAND-12 Health Status Inventory algorithm. The endpoints were the differences in the global score, PHC score and MHC score between the immediate and 2-month postpartum periods.

Results

Five hundred and eight women responded to the questionnaire. Multivariable analysis revealed that the mean difference in the global score between the immediate and 2-month postpartum periods decreased in women who had undergone an emergency caesarean (-4.86 points, p = 0.03) and increased in multiparous women (+1.80 points, p = 0.04). The MHC score decreased with current professional activity compared with no professional activity (-2.7 points, p = 0.04), and the PHC score decreased by 3.5 points between 37 and 42 weeks of gestation (p = 0.04). Moreover, HRQoL was negatively associated with the Quality of Prenatal Care Questionnaire score in all dimensions.

Conclusions

Emergency caesarean, multiparity, current professional activity, gestational age at delivery, and perceived quality of prenatal care were associated with changes in HRQoL postpartum. These associations should be interpreted with caution because some observed differences did not reach the minimal clinically important difference.