Abstract
BACKGROUND: Pregnancy is a natural physiological process. However, it significantly affects mothers' health-related quality of life through various physical, psychological, social, and environmental changes. Understanding the determinants of health-related quality of life during antenatal care can guide maternal health interventions. OBJECTIVES: To assess health-related quality of life and associated factors among mothers attending antenatal care in South Wollo Zone public hospitals, Northeast Ethiopia. DESIGN: An institution-based cross-sectional study. METHODS: Systematic random sampling method was used in five randomly selected hospitals among mothers attending antenatal care from March 1 to 30, 2024. Health-related quality of life was measured using World Health Organization Quality of Life - BREF (WHOQOL-BREF) questionnaire. Data were entered into EpiData 3.1 and exported to SPSS 25 for analysis. Multivariable linear regression analysis was performed by selecting variables with a p-value of <0.25 in simple linear regression. Then, variables having p-value <0.05 at 95% confidence interval with an unstandardized B-coefficient were considered significant predictors. RESULTS: The mean scores for physical, psychological, social relationship, and environmental health-related quality of life domains were 71.0, 72.1, 66.1, and 65.7, respectively. Among the participants, 76.1% rated their health-related quality of life as neither poor nor good, and 42.3% reported being neither dissatisfied nor satisfied in terms of their health satisfaction. Physical health was negatively affected by pregnancy-related illness, older age, and depression. Psychological domain declined with depression, rural residence, and perceived social stigma. Depression and perceived social stigma impaired social relationships. Environmental quality of life was lower among depressed participants, rural residents, and those reporting current alcohol use. CONCLUSION: Overall, participants demonstrated moderate health-related quality of life across all domains, with most perceiving their health status as neutral. Health professionals should follow holistic care, including physical, psychological, social, and environmental interventions. Targeted interventions are needed to address negatively associated predictor variables for all domains of health-related quality of life.