Assessing the Quality of Life of Pregnant Women in Romania: Socioeconomic, Health, and Obstetric Factors and the Validation of the WHOQOL-BREF Instrument.

Abstract

Pregnancy is a transformative stage in a woman's life, marked by significant physical, emotional, and social changes. This study had three main objectives: (1) to assess the quality of life (QoL) of pregnant women in Romania, (2) to identify the sociodemographic, health, and obstetric factors influencing their QoL and (3) to examine the psychometric properties of the WHOQOL-BREF questionnaire within the Romanian context, determining its effectiveness in evaluating QoL during pregnancy. Methods: A cross-sectional analytical survey was conducted between January and July 2023 among pregnant women in Romania, targeting a geographically diverse sample from urban and rural areas. Eligible participants were Romanian citizens aged 18 or older. Data were collected through an online self-administered questionnaire using Google Forms, with informed consent obtained electronically. The survey included demographic, obstetric, and health-related variables alongside the WHOQOL-BREF tool, which evaluates QoL across four dimensions: Physical, Psychological, Social Relationships, and Environment. Statistical analysis involved confirmatory factor analysis, reliability testing (Cronbach's α and McDonald's ω), and comparisons using Welch's t-tests and ANOVA. Results: A total of 1550 valid responses were analyzed. The WHOQOL-BREF demonstrated excellent internal consistency (Cronbach's α > 0.9 across all dimensions). Women with higher education and stable employment reported significantly higher QoL scores in physical and psychological dimensions. No significant differences were found based on pregnancy trimester, previous births, or participation in prenatal classes, although trends suggested slight advantages for participants in prenatal education. Women delivering in private hospitals or non-hospital settings reported better psychological and physical QoL than those delivering in public hospitals. Support from partners and urban residency positively influenced perceived QoL. Conclusions: The WHOQOL-BREF is a reliable tool for assessing QoL in pregnant women in Romania. The study highlights the role of education, employment, and delivery location in influencing QoL, emphasizing the need for targeted support for vulnerable groups during pregnancy.