Boutib Amal, Chergaoui Samia, Azizi Asmaa, Achak Doha, Saad El Madani, Hilali Abderraouf, Nejjari Chakib, Youlyouz-Marfak Ibtissam, Marfak Abdelghafour
Laboratory of Health Sciences and Technologies, Higher Institute of Health Sciences, Hassan First University of Settat, 26000, Settat, Morocco.
Euro-Mediterranean University of Fez (UEMF), Fez, Morocco.
Heliyon. 2024 May 31;10(11):e32276. doi: 10.1016/j.heliyon.2024.e32276. eCollection 2024 Jun 15.
During the postpartum period, understanding women's well-being, specifically their Health-related Quality of Life (HRQoL), is vital for comprehensive healthcare.
Our study aims to explore the HRQoL and its associated factors in Moroccan women after vaginal birth (VB) and cesarean section (CS).
In this cross-sectional study we assessed the HRQoL and its associated factors among Moroccan women who gave birth at the provincial hospital center of Settat. We gathered data from 566 women, using the EQ-5D-5L instrument alongside questionnaires about socioeconomic and obstetrical aspects. The assessment was conducted utilizing the improved Relative to an Identified Distribution (RIDIT) approach, and we employed a multiple linear regression model to pinpoint the associated factors.
A total of 566 women were included in our study. Our results revealed that the HRQoL in women who underwent CS was significantly lower than in VB women (EQ-5D index score = 0.30 ± 0.28 vs 0.61 ± 0.31; p < 0.0001). Similarly, the CS reduced the EQ-VAS score (mean difference = -10.73 ± 3.78; p < 0.0001). The CS was associated negatively with problems in mobility (ARI = 55 % [42-67], p < 0.0001), autonomy (ARI = 67 % [57-80], p < 0.0001), and usual activities (ARI = 56 % [42-69], p < 0.0001). Also, CS was associated with pain/discomfort (ARI = 47 % [34-60], p < 0.0001) and anxiety/depression (ARI = 3 % [-5.8-12.6], p = 0.31). The women who had birth complications had the worst HRQoL (EQ-5D index score = 0.32) compared to those who had no complications (EQ-5D index score = 0.56). Likewise, women who had postpartum complications had the worst HRQoL (EQ-5D index score = 0.39 vs EQ-5D index score = 0.54).
The results highlighted that mode of birth, childbirth complications, and postpartum complications are strongly associated with women's HRQoL. The EQ-5D-5L dimensions were affected after delivery. Hence, there is a requirement to create specialized initiatives for overseeing postpartum HRQoL, aiming to enhance the quality of maternal healthcare.
在产后阶段，了解女性的健康状况，特别是她们的健康相关生活质量（HRQoL），对于全面的医疗保健至关重要。
我们的研究旨在探讨摩洛哥女性经阴道分娩（VB）和剖宫产（CS）后的HRQoL及其相关因素。
在这项横断面研究中，我们评估了在塞塔特省医院中心分娩的摩洛哥女性的HRQoL及其相关因素。我们使用EQ-5D-5L工具以及关于社会经济和产科方面的问卷收集了566名女性的数据。评估采用改进的相对于已识别分布（RIDIT）方法进行，我们使用多元线性回归模型来确定相关因素。
我们的研究共纳入了566名女性。我们的结果显示，接受剖宫产的女性的HRQoL显著低于经阴道分娩的女性（EQ-5D指数评分=0.30±0.28对0.61±0.31；p<0.0001）。同样，剖宫产降低了EQ-VAS评分（平均差异=-10.73±3.78；p<0.0001）。剖宫产与行动能力问题（ARI=55%[42-67]，p<0.0001）、自主性问题（ARI=67%[57-80]，p<0.0001）和日常活动问题（ARI=56%[42-69]，p<0.0001）呈负相关。此外，剖宫产与疼痛/不适（ARI=47%[34-60]，p<0.0001）和焦虑/抑郁（ARI=3%[-5.8-12.6]，p=0.31）有关联。与没有并发症的女性相比，有分娩并发症的女性的HRQoL最差（EQ-5D指数评分=0.32）（EQ-5D指数评分=0.56）。同样，有产后并发症的女性的HRQoL最差（EQ-5D指数评分=0.39对EQ-5D指数评分=0.54）。
结果突出表明分娩方式、分娩并发症和产后并发症与女性的HRQoL密切相关。分娩后EQ-5D-5L维度受到影响。因此，需要制定专门的举措来监督产后HRQoL，旨在提高孕产妇医疗保健质量。
