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Multicenter Study
. 2025 Aug 25;15(1):31294.
doi: 10.1038/s41598-025-10699-3.

Pregnancy variables that impact postpartum quality of life: a multicenter prospective study

Isabel Artieta-Pinedo  1   2   3 , Carmen Paz-Pascual  4   5   6 , Paola Bully  7 ; ema-Q Group; Maite Espinosa  8
Collaborators, Affiliations
Multicenter Study

Pregnancy variables that impact postpartum quality of life: a multicenter prospective study

Isabel Artieta-Pinedo et al. Sci Rep. .

Abstract

Postpartum quality of life is a multidimensional variable regarding a woman's own assessment of her health, which frequently deteriorates after childbirth. To identify the physical, cognitive, emotional, cultural and/or social factors present during pregnancy that are most related to postpartum Quality of Life (QoL). A team of experts identified some factors that could influence the experience of pregnancy, childbirth and postpartum. A longitudinal study was carried out in the public health service of the Basque Country. Participants were recruited consecutively and through peer snowball sampling. During pregnancy, were evaluated anxiety (STAI), depression (EPDS), coping style (NuPCI), self-efficacy (CBSEI), fear of childbirth (WEQ-A), partner support (PSEQ) and substance use (EMAeHealth); along with sociodemographic variables. In the postpartum period, information about type of delivery and quality of life (SF-12) was collected online. A multivariate analysis was carried out. 92 women answered the questionnaires during pregnancy (M = 28 weeks, SD = 7.03) and in the postpartum (M = 37 days, SD = 30.13). Multigroup structural equation models revealed that fear of childbirth and emotional state during pregnancy were significantly associated with postpartum quality of life (QoL), with patterns differing by educational level. Although no statistically significant interactions were found, standardized path coefficients indicated clinically meaningful differences. Most effect sizes ranged from moderate to large (β ≥ 0.30), and explained variance exceeded thresholds for substantial predictive power (R2 = 0.30-0.74), reinforcing the practical significance of the findings despite sample size limitations. Some variables in pregnancy, especially emotional state and fear of childbirth, have a negative impact on postpartum QoL. Early intervention on these variables can increase women's well-being in the medium and long term.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The Basque Country Clinical Research Ethics Committee (PI2019110) approved the study in accordance with the relevant guidelines and regulations. Prior to participating in the study, all the participating women were informed of the study and an informed consent was provided by all the participants for this study. The consent and information sheet had previously been approved by the Basque Country Clinical Research Ethics Committee. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Models for health-related quality of life during the postpartum period.
Fig. 2
Fig. 2
Models for the mental component of health-related quality of life during the postpartum period.
Fig. 3
Fig. 3
Models for the physical component of health-related quality of life during the postpartum period.
See this image and copyright information in PMC

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