印度北部中低社会经济社区中受孕延迟女性的生活质量及其决定因素：一项横断面研究。
Quality of life and its determinants in women with delayed conception in low-mid socioeconomic neighbourhoods of Northern India: a cross-sectional study.
作者信息
Gadapani Pathak Barsha, Mburu Gitau, Habib Ndema, Kabra Rita, Kiarie James, Chowdhury Ranadip, Dhabhai Neeta, Mazumder Sarmila
机构信息
Society for Applied Studies, New Delhi, New Delhi, India.
Centre for International Health, Faculty of Medicine, University of Bergen, Bergen, Norway.
出版信息
BMJ Public Health. 2025 Apr 20;3(1):e001740. doi: 10.1136/bmjph-2024-001740. eCollection 2025 Jan.
BACKGROUND
The inability to conceive or delay in conception has negative and multidimensional effects on health and well-being, daily functioning and societal interactions. This study assesses the impact of delayed conception on quality of life (QoL) among Indian women with delayed conception and evaluates the Fertility Quality of Life (FertiQoL) questionnaire's reliability and construct validity in this population.
METHODOLOGY
A cross-sectional study of 1530 women aged 18-30, who had not conceived over a period of 18 months, was conducted in low-to-mid-socioeconomic neighbourhoods in Delhi, India. The 24-item core module of the FertiQoL questionnaire was used to assess participants' QoL. Researchers analysed data to identify factors associated with QoL scores and evaluated FertiQoL's internal consistency and validity. Data were collected between July 2020 and August 2021.
RESULT
The average FertiQoL score was 31.71 out of 100, indicating a moderately low QoL. Among the subscales, emotional (mean: 29.0) and mind-body domains (mean: 25.4) scored the lowest, while the relational domain scored the highest (mean: 50.7). Factors negatively associated with QoL included a longer duration of delayed conception (β=-0.3, 95% CI: -0.5 to -0.1), husbands fathering children with other partners (β=-1.1, 95% CI: -1.7 to -0.38), domestic violence-emotional (β=-3.5, 95% CI: -4.5 to -2.4), verbal (β=-3.2, 95% CI: -4.7 to -1.7), physical abuse by family (β=-3.6, 95% CI: -5.5 to -1.6), lack of financial support (β=-3.2, 95% CI: -5.2 to -1.2), social pressures (β=-1.6, 95% CI: -2.3 to -0.9) and physical health issues (β=-0.9, 95% CI: -1.7 to -0.2). The FertiQoL tool demonstrated acceptable reliability (Cronbach's alpha=0.64) and good construct validity (confirmatory factor analysis), confirming its utility in this population.
CONCLUSION
Indian women experiencing delayed conception have reduced QoL, particularly in emotional and mind-body domains, due to various psychosocial and socioeconomic challenges. The FertiQoL questionnaire proved to be a reliable and valid tool for assessing QoL in this context. Psychosocial interventions addressing emotional, social and economic stressors are urgently needed to improve their well-being. Future research should include men to better understand the holistic challenges faced by couples struggling to conceive.
背景
无法受孕或受孕延迟会对健康、幸福、日常功能及社会交往产生负面的多方面影响。本研究评估受孕延迟对印度受孕延迟女性生活质量（QoL）的影响，并评估生育生活质量（FertiQoL）问卷在该人群中的信度和结构效度。
方法
在印度德里中低社会经济水平社区，对1530名年龄在18至30岁、18个月内未受孕的女性进行了一项横断面研究。使用FertiQoL问卷的24项核心模块评估参与者的生活质量。研究人员分析数据以确定与生活质量得分相关的因素，并评估FertiQoL的内部一致性和效度。数据收集于2020年7月至2021年8月期间。
结果
FertiQoL平均得分为31.71（满分100分），表明生活质量处于中等偏低水平。在各子量表中，情感领域（均值：29.0）和身心领域（均值：25.4）得分最低，而关系领域得分最高（均值：50.7）。与生活质量负相关的因素包括受孕延迟时间较长（β=-0.3，95%置信区间：-0.5至-0.1）、丈夫与其他伴侣育有子女（β=-1.1，95%置信区间：-1.7至-0.38）、情感虐待（β=-3.5，95%置信区间：-4.5至-2.4）、言语虐待（β=-3.2，95%置信区间：-4.7至-1.7）、来自家人的身体虐待（β=-3.6，95%置信区间：-5.5至-1.6）、缺乏经济支持（β=-3.2，95%置信区间：-5.2至-1.2）、社会压力（β=-1.6，95%置信区间：-2.3至-0.9）和身体健康问题（β=-0.9，95%置信区间：-1.7至-0.2）。FertiQoL工具显示出可接受的信度（Cronbach's alpha=0.64）和良好的结构效度（验证性因素分析），证实了其在该人群中的实用性。
结论
由于各种心理社会和社会经济挑战因素，经历受孕延迟的印度女性生活质量下降，尤其是在情感和身心领域。FertiQoL问卷在这种情况下被证明是评估生活质量的可靠有效工具。迫切需要针对情感、社会和经济压力源的心理社会干预措施来改善她们的幸福感。未来的研究应纳入男性，以更好地了解难以受孕的夫妇所面临的整体挑战。
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