Abstract
BACKGROUND: The physical and psychological challenges faced by postpartum women adversely affect their health-related quality of life (HRQoL). However, the influence of urinary incontinence (UI), sexual dysfunction, and depressive symptoms on HRQoL across the first postpartum year remains unclear. PURPOSES: This study was designed to investigate the association of UI, sexual dysfunction, and depressive symptoms with HRQoL and to examine changes in HRQoL across the initial 12-month postpartum period. METHODS: The participants ( n =613) completed the study questionnaire at four time points: 4-6 weeks and 3, 6, and 12-months postpartum. The questionnaire was mailed from a medical center maternity unit and included the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form, Female Sexual Function Index, the Center for Epidemiologic Studies Depression Scale, and the 36-item Short-Form Health Survey. RESULTS: Moderate to severe UI (β =-2.99), sexual satisfaction (β =-0.43), and lubrication (β =0.44; all p <.05) were associated with physical HRQoL over the 12-month postpartum period. Mental HRQoL was influenced by moderate to severe UI (β =-1.3), sexual satisfaction (β =0.61; both p <.05), and depressive symptoms (β =-11.07; p <.001). The lowest p hysical and mental HRQoL scores were identified in the first month postpartum (all p <.001). Physical HRQoL increased more significantly at 6 and 12 months than at 3-months postpartum (both p ≤.001). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The first month postpartum represents a critical period for assessing HRQoL, when it is lowest. UI severity, sexual satisfaction, lubrication, and depressive symptoms were all shown to impact HRQoL significantly, indicating the need for proactive evaluations and tailored interventions by healthcare providers. Future research should identify interventions that effectively improve HRQoL during the postpartum period.