Profiles and associated factors of prenatal psychological symptoms and their association with health-related quality of life among pregnant women: a cross-sectional study

Objectives: To cluster prenatal psychological symptoms into different profiles and investigate prenatal psychological symptoms' sociodemographic, health-related and pregnancy-related factors. Furthermore, health-related quality of life was compared across prenatal psychological symptom profiles.

Design: Cross-sectional study.

Setting: Obstetrics clinics of two university-affiliated, governmental, tertiary hospitals in Xi'an City, Northwestern China.

Participants: Between June and August 2020, 1020 pregnant women who maintained their health assessment appointments at the two research sites participated in this study.

Primary and secondary outcome measures: This study's primary outcome was the creation of latent profiles of prenatal psychological symptoms. These were represented by the coexisting symptoms of three common psychological disorders: depression measured using the eight-item Patient Health Questionnaire, anxiety measured using the Generalised Anxiety Disorder-7 and stress measured using the Pregnancy Stress Rating Scale. Secondary outcomes included potential sociodemographic, health-related and pregnancy-related factors associated with prenatal psychological symptoms, which were measured using a researcher-designed information sheet, and health-related quality of life, measured using the 5-Level EuroQol 5-Dimension questionnaire.

Results: Prenatal psychological symptoms were classified into three latent profiles using latent profile analysis: low (62.9%), moderate (31.3%) and severe (5.8%). Factors associated with the severity of prenatal psychological symptoms included age, relationship with partner, relationship with mother-in-law, history of gynaecological diseases, history of dysmenorrhoea, stage of pregnancy, unplanned pregnancy, severity of vomiting symptoms and abnormal pregnancy indicators. Moreover, an inverse association was identified between the severity of prenatal psychological symptoms and health-related quality of life.

Conclusions: Considering the high prevalence of prenatal psychological symptoms and their adverse effects on health-related quality of life, the assessment of prenatal psychological symptoms should be integrated into prenatal healthcare and made routine practice. Investigating the relevant associated factors would be beneficial for identifying vulnerable individuals.