Table 3 Factors Associated with Quality of Life During Pregnancy

Aquino NM

(2009) [17]

Sexual Violence *

Women who had experienced sexual violence had significantly lower PCS and MCS (PCS 42.2, SD = 5.3 and MCS 37.4, SD = 11.2) than women who had no history of sexual violence (PCS 51.0, SD = 7.5 and MCS 48.1, SD = 10.2, p < 0.001).

Chan OK (2010) [18]

Nausea and vomiting*

PW without symptoms of NVP: PCS: 67.92; MCS 68.36; PW with moderate symptoms: PCS: 56.93; MCS 60.86; PW with severe symptoms: PCS: 50.01; MCS: 50.23

The variations between the PCS and MCS of the 3 groups are all significant. (P < 0.01). All QOL dimensions are affected by NVP (p < 0.05)

Chang SR (2014)

[39]

Pregnancy stage *, Experience of infertility *, Medically Assisted Reproduction *, Number of Pregnancies, Spontaneous Abortions, Parity *, Medical Condition *, Pregnancy wanted *

Factors associated with PCS: Pregnancy stage (beta = − 7.79, p < 0.001), experience of infertility (beta = − 6.39, p = 0.03).

Factors associated with MCS: stage of pregnancy (beta = 3.31, p < 0.001), number of pregnancies (beta = − 7.12, p = 0.01), medical condition beta = − 4.08, p = 0.04).

Factors associated with overall QOL: Pregnancy stage (beta = 1.64, p = 0.01), desired pregnancy (beta = 5.52, p = 0.04), medical condition (beta = − 5.29, p < 0.001).

Coban A. (2011) [35]

Back pain

No significant difference between PBP and NBP in the different areas of WHO-QOL-BREF: physical health p = 0.229; psychological health p = 0.069; Social relationship p = 0.125; Environment p = 0.790

Da Costa D (2009) [19]

Age*

, Education *,

Income*,

Professional status*

, Marital status *

, Parity *

, Weeks pregnant

, Medical history*

, Medical complications during pregnancy *

, Anxiety related to pregnancy *

Partner Support *

, Social Support *

, Sleep Problems *

, Depressive symptoms *

, Life Events *

Multivariable analysis: Sleep problems affected most QOL components (PF: b = − 0.17, p < 0.007; PR: b = − 0,19, p = 0.002; BP: b = − 0,35, p < 0.0001; GH: b = − 0.21, p < 0.0001; VT: b = − 0.25, p < 0.0001; SF: b = − 0.26, p < 0.0001, MH: b = − 0.20, p < 0.0001).

A depressive mood was an independent determinant in 6/9 of the QOL dimensions (BP: b = − 0.13, p = 0,.039, GH: b = − 0.28, p < 0.0001, VT: b = − 0.40, p < 0.0001, SF = − 0.27, p < 0.0001; ER: b = − 0.50, p < 0.0001, MH: b = − 0.59, p < 0.0001), and anxiety also affected physical activity and limitations due to physical state.

The life experience of the past year had a negative impact on physical activity, social functioning and mental health scores. Having complications during pregnancy affected physical activity and social functioning. Age, professional status, educational level and medical problems were linked to only one parameter of SF36.

Dall’Alba V (2015) [20]

Epigastralgia *, Gastroesophageal Reflux *

Epigastralgia: significant decrease in PR (p = 0.009) and of SF (p = 0.020); RGO: significant decrease in PR (p = 0.004) and of ER (p = 0.002)

De Pascalis L. (2012) [40]

Medically assisted fertility*

PW having a medically assisted pregnancy: PCS: 40.0 then 35.97; MCS: 52.32 then 53.02; PW having conceived spontaneously: PCS: 44.78; then 38.86. MCS: 51.08 then 53.65

Physical well-being scores significantly lower in the medically assisted pregnancy group than in the spontaneous conception group (P = 0.033) in the categories: physical health limitations, vitality, social functioning. Physical well-being scores of PW with medically assisted pregnancy decreased during pregnancy, more significantly than spontaneously conceived PW. (P = 0.008)

Elsenbruch S. (2006) [21]

Social support*

Low social support was statistically associated with a reduced QOL (For PCS: F = 11.53, P < 0.001, For MCS: F = 90.60, P < 0.001). On the contrary, the group where social support was high had better QOL. (P < 0.001)

Emmanuel EN (2012)

Age, Relationship status, Length of relationship, Level of education, Parity, Timing of first antenatal visit, Socialupport

Social support: beta = 0.21 [− 0.04,0.47] was not significant during pregnancy

Emmanuel EN (2014) [41]

Age *, Number of pregnancies *, Marital status *, Ethnicity *, Maternal stress *

PW between 25 and 29 years of age had a better RF, PR, BP than the others (PF: F = 11.07 P = 0.001; PR: F = 5,17 p = 0,006; BP: F = 11.01 p = 0.001)

Caucasian and Asian PW had higher SF and MH scores than other ethnic groups (SF: F = 2.65, p = 0.02; MH: F = 2.42 p = 0.03)

Single PW had higher SF and MH scores than other ethnic groups (SF: F = 2.65, p = 0.02; MH: F = 2.42 p = 0.03)

A significant relationship is found between the different components of SF12 and maternal stress except for BP (PH r = − 3.87; PR r = − 7.79; BP: r = − 7.79; GH: r = − 6.63; VT = − 7.70; SF: r = − 12.61; ER: r = − 12.66; MH: r-12.80 p < 0.01)

Fatemeh A (2010) [32]

Age*, Gestational age*, Gravidity*,Education*, Wanted pregnancy*, life satisfaction*, Income

Age: < 25 years: GH = 63.68; PF = 64.71; SF = 66.37; MH = 68.33; > 25 years: GH = 60.44 p = 0.009; PF = 20.60 p = 0.010; SF = 61.47 p = 0.009; MH = 64.81 p = 0.018

Gestationnal age: < 20 weeks: PF = 65.51; BP = 56.89; > 20 weeks: PF = 60.72 p = 0.013; BP = 57.22 p = 0.022

Gravid 1 N: GH = 63.23; PF = 62.93; RP = 56.86; SF = 65.35; MH = 67.73; VT = 56.97; > 2 N: GH = 55.42 p = 0 .000; PF = 56.16 p = 0.011; RP = 52.09 p = 0.038; SF = 56.52 p = 0.002; MH = 60.09 p = 0.000; VT = 52.56 p = 0.048

Significant association between levels of education and PF and MH, between wanted pregnancy and RE and MH, life satisfaction and SF and MH (figures not available)

Gezginç K (2008) [34]

Obsessive Compulsive Disorder

Patients with OCD: Physical health: 49.92 +/−  15.44 Mental health: 46.20 +/−  15.98 Social relationships 44.96 +/−  15.00 Environment 50.32 +/−  9.88

PW control group: Physical health: 61.96 /−  10.08 and p = 0.002; Mental health: 66.32 +/−  10.47and p < 0.0001; Social relations: 67.12 +/−  11.92 and p < 0.0001; Environment 69.60 +/−  10.23 and p < 0.0001

Gharacheh M.

(2015) [22]

Domestic violence*

6 SF36 sub-scales are lower for abused women than for non-abused women: PR (p = 0,041) GH (p = 0.003) PCS (p = 0.009) VT (p = 0.011) SF (p = 0.05) ER (p = 0.037) MH (p = 0.035) MCS (p = 0.07)

Haas JS (2004) [42]

Age, Ethnicity, Marital Status,

Level of Education,

Body Mass Index, Obesity *

, Financial problems*,

Physical exercise *,

Depressive Symptoms *,

Pre-conception smoking *,

History of alcohol addiction *,

Symptoms associated with pregnancy *,

Medical background,

Medical complications

Factors associated with poor health: financial problems (OR = 2.11, IC (1.49–2.98)), low physical function before pregnancy (OR = 1.99, IC (1.37–2.88)), depressive symptoms (OR = 2.30; IC (1.61–3.29)), obesity = (OR = 1.70; IC (1.16–2.48), lack of physical exercise, (OR = 1.12; IC (0.77–1.63) Smoking during the 3 months prior to conception (OR = 1.04; IC (0.65–1.68)), History of alcohol dependence (OR = 1.55, IC (1.00–2.39))

Indigestion was associated with poor physical function (OR = 1.49; IC (1.04–2.13)).

Dizziness (OR = 2.06; IC(1.57–2.71), back pain (OR = 1.71; IC(1.27–2.31)), breathlessness (OR = 1.32; IC(1.02–1.71)) were associated with a low vitality score. Dizziness, indigestion, shortness of breath and sleep disorders were associated with depressive symptoms.

Hama K (2008)

[51]

Number of pregnancy*

PF, RP, GH: no significant differences between nulliparous and multiparous women

BP and VT: scores higher in multiparous in the 3rd and 4th monthes of pregnancy, and lower in the 9th month of pregnancy; SF: higher in multiparous from the 3th month to the 7th month and lower in the 9th month; RE and MH: scores higher in multiparous up to 6th month pregnancy (p < 0,05) (no figures avalaible)

Jommen J (2005) [23]

Depression*, Anxiety*.

The PW group with depression had significantly lower QOL scores for all SF36 parameters (p < 0.05) except for physical function (p = 0.73) and vitality (p = 0.09). The PW group with clinically significant anxiety levels had significantly lower QOL scores in terms of physical pain (p = 0.02) and general health (p < 0.001)

Lacasse A (2008) [24]

Nausea and Vomiting *, Ethnicity *, Age *, Medical Insurance, employment, Educational level, Income, Physical exercise *, Alcohol and tobacco *

PW without NVP: PCS = 49,5; MCS = 49; PW with NVP: PCS = 43; MCS = 46 P < 0.001 AND P = 0.003

PCS age: b = − 0.32 p = 0.006; Country of birth MCS: b = 3.02 P = 0.035; Hispanic ethnicity MCS: b = 4.88 p = 0.035

Physical exercise: PCS: b = 3.47 p = 0.001 MCS: b = 2.17 p = 0.031; Coffee: PCS: b = 2.84 p = 0.006; Alcohol:: PCS: b = 3.38 p = 0.045

Lau Y (2011) [25]

Perceived Stress *

Significant association between perceived stress and PCS (beta = − 0.501, p < 0.001) and MCS (b = − 0.115, p < 0.001)

Li J (2012) [26]

Depression*, Age*, Body Mass Index*, Educational Level*

Physical exercise, History of smoking, History of alcohol abuse, Income*, Wanted pregnancy, Weeks pregnant*, Parity, History of abortion, Pregnancy complications

The PW group presenting depression had significantly lower QOL scores for all SF36 parameters (p < 0.002)

PW not depressed: PCS = 49.13 (6.95); MCS = 48.67 (7.33)) (p < 0.001); PW depressed: PCS = 46.43 (7.42); MCS = 39.62 (7.94) (p < 0.001)

Age: PCS r = − 0.170 (p < 0.001); MCS: r = 0.108 (p < 0.05); BMI: MCS: r = 0.114 (p < 0.05); Education level: MCS r = 0.203 (p < 0.001)

Monthly income: MCS r = 0.183 (p < 0.001); Week of pregnancy: PCS: r = 0.145 (p < 0.001); MCS r = 0.118 (p < 0.05)

Multivariable: PCS: EPDS: beta = − 0.232 (p < 0.0001); Age: beta = − 0.179 (p < 0.0001); WP: beta = − 0.129 (p = 0.004); Employment: beta = − 0.111 (p = 0.012); Marital status: beta = − 0.107 (p = 0.017); MCS: EPDS: beta = − 0.662 (p < 0.0001); BMI: beta = 0.129 (p < 0.0001); Wanted pregnancy: beta = 0.086 (p = 0.018)

Liu L

(2013) [27]

Ethnicity

Black patients: PF = 58; PR = 52; BP = 69; GH = 71; VT = 47; SF = 72; ER = 63; MH = 79; White patients: PF = 77; PR = 78; BP = 83; GH = 83; VT = 58, SF = 87; ER = 89; MH = 83. Black women had significantly lower QOL scores in physical activity (p < 0.001), physical limitation (p < 0.001), physical pain (p = 0.02) (P = 0.01), social functioning (p = 0.002), limitations related to mental state (p < 0.001). After adjusting for depressive symptoms, social support and BMI, these differences become no longer statistically significant.

Mckee MD (2001) [28]

Depression*

Social support*

Depression is strongly and negatively correlated with all subscales of SF 36 MH (r = − 0,69), VT (r = − 0,63), SF (r = − 0.62), and ER (r = − 0.54) Social support was related to MH (r = 0.24), ER (r = 0.19), and SF (r = 0.14).

Moyer CA (2009) [30]

Optimism*

Optimism is positively associated with MCS (p = 0.001), VT (p = 0.041), and MH (p < 0.001)

Nakamura Y (2012) [36]

Comfort*,

Hospitalisation*

The sense of comfort and the 6 areas of HRQOL were significantly lower for inpatients than for ambulatory PW and non-pregnant women (p < 0.05 and p = 0.001). A significant correlation was found between subjective comfort and QOL in vitality (p < 0.001) and mental health (p < 0.001)

Nicholson WK

(2006) [31]

Ethnicity*, Income*, Social Support*

Depressive Symptoms*, Multi-parity*

Chronic illness

Ethnicity: African Americans / Whites: PF: − 15 (− 22;-8) RP: − 28 (− 41, − 15), GH: − 11 (− 19; − 13)(, VT: − 13(− 28;-3): SF: − 7 (− 8; − 6),

Income: GH -10 (− 17; − 3), SF -4 (− 5, − 3), MH -9 (− 15; − 4); Social support: PR: 30 (6,55) GH: 9 (5,15), MH: 14 (12; 16)

Multi-parity (>  2 previous deliveries): PR: 18 (7;30), SF: 17 (16, 18); Depressive symptoms: PR: − 50 (p = 0.006); BP: − 12 (p = 0.01); GH: − 10 (p = 0.01); VT = − 20 (p > 0.001); SF = − 38 (p < 0.01); ER: − 40 (p < 0.01); MH = − 24 (p < 0.01); Still significant in multivariable analysis

Olsson C (2004) [32]

Back pain

The QOL was lower in the PW group with back pain group (16 ± 16) (p = 0.000), also found in the sleep subcategories

(P = 0.003), energy (p = 0.024), pain (p = 0.000) and physical mobility (p = 0.000). The PW group with back pain had a higher rate of occupational withdrawal (57%, p = 0.005), aptitude for household work (62%, p = 0.002), Social life (35%, p = 0.007) and leisure time (68%, P = 0.001)

Ramirez-Vélez (2011) [34]

Age*, Educational Status*, Socioeconomic levels*, Work status*, Marital Status*, Gestational weeks

Age: PF: r = − 0.17 (p < 0.05); Educational Status: GH: r = 0.34 (p < 0.001) Socioeconomic levels: PR r = 0.17 (p < 0.05); GH r = 0.29 (p < 0.001); SF: r = 0.19 (p < 0.05); ER: r = 0.27 (p < 0.01); MH: r = 0.22 (p < 0.01) Occupation (housewife): PR: r = 0.20 (p < 0.01); GH: r = 0.19 (p < 0.05); Marital Status (Being married or cohabiting): PF: r = 0.15 (p < 0.05) PR: r = 0.16 (p < 0.05) GH: r = − 0.22 (p < 0.01) VT: r = 0.19 (p < 0.05) SF: r = − 0.23 (p < 0.01) ER: r = − 0.19 (p < 0.01) MH: r = − 0.25 (p < 0.01)

Setse R (2008) [43]

Depressive symptoms*

In the 1st trimester: PW not depressed: PF = 82; PR = 59; BP = 77; GH = 65; VT = 47; SF = 81; ER = 87; MH = 79

Depressed PW: PF = 78; PR = 39; BP = 59; GH = 51; VT = 35; SF = 54; RE = 41; MH = 57

Depressed PW had a significantly worse QOL on the following SF36 conditions: physical pain, vitality, social functioning, functioning related to mental health, mental health. These PW had QOL scores of 10–23 points and 19–31 points lower in the 2nd and 3rd trimester

Shishehgar S (2014) [33]

Perceived stress during pregnancy *

Significant relationship between QOL and stress rate (p = 0.026, r = 0.007)

Tavoli Z (2016)

Domestic violence*

Non-abused women: PF = 68.7; RP 43.2; BP = 70.7; GH = 69.5; VT = 55.6; SF = 70.5; RE = 46.0; MH = 63.5;

Abused women: PF = 53.9 (p < 0.0001); RP = 25.8(p < 0.0001); BP = 64.2 (NS); GH = 61.4 (p < 0.01); VT = 43.5(p < 0.0001); SF = 55.8 (p < 0.0001); RE = 20.1 (p < 0.0001); MH = 55.3(p < 0.003);

General Health: physical violence OR = 2.13 (p = 0.03), Mental Health: psychological violence OR = 1.24 (p = 0.04)

Tendais I (2011) [44]

Physical activity*

PW who had low physical activity before and ^1st trimester had better mental health at 19–24 WP than active PW who became less active

10–15 PW (p = 0.015).

Tsai SY (2016) [45]

Sleep patterns

Pittsburgh Sleep Quality Index: T1: MCS b = − 1.40 PCS b-1.07; T2: MCS b = − 0.74 PCS b = − 0.88; T3: MCS b = − 1.42 PCS b = − 0.68; P < 0.01

Vinturache A (2015) [47]

Medically assisted reproduction*, Maternal age

Gravidity, Pre-pregnancy BMI*, Physical function before pregnancy*, Mental function before pregnancy

Prior to 25 WP, AC women (who had MAR) had better mental QOL (p > 0.05) but a lower physical health score (p = 0.031) than SC women (spontaneous conception). At 34–36 WP, one difference persisted for the physical symptoms between the 2 Groups (p < 0.05). No post-partum health-related QOL differences.

Wang P (2013) [48]

Employment *, Happy being pregnant *, Education *, Primipara *, Age

Employment: b = − 4.05, p < 0.001 for mental health; B = − 3.06 p = 0.002 for social health; B = − 3.39, p = 0.001 for general health; Happy being pregnant: b = 8.70, p = 0.01 in the mental health component and b = 6.94, p = 0.03 for general health; level of education b = − 2.10, p = 0.04 for the mental health component Primipara: b = 0.04, p = 0.04 for general health