Does health-related quality of life change across pregnancy trimesters? A systematic review and meta-analysis.
Hyunjeong Shin, Inhae Cho, Sung-Jin Kim
PMID 41531401WHAT IT FOUND
Across 13 studies of 4,809 pregnant women, overall health-related quality of life did not differ between first and second or first and third trimesters, but was lower in the third than the second.
Key findings
01When studies were pooled, overall health-related quality of life showed no statistically significant difference between the first and second trimesters or between the first and third trimesters, but third-trimester scores were significantly lower than second-trimester scores.
02In studies that measured mental and physical domains separately, mental health scores increased from the first to the second trimester and decreased from the second to the third, while physical health scores decreased only from the second to the third.
03Pooled trajectories varied by measurement instrument, so the review did not find one consistent pattern across questionnaires.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The included studies were observational, so the review describes measured patterns rather than testing whether care or pregnancy stage causes a change. Heterogeneity was high in every overall comparison, and the pattern changed depending on the questionnaire used. Many studies used generic health-related quality of life tools, which may miss pregnancy-specific concerns such as fetal worries, body image changes, or childbirth anxiety. Trimester categories treat each trimester as uniform, so smaller month-to-month changes may be hidden. Cultural and healthcare system differences across the ten countries were not systematically addressed. The review included studies of pregnant women without complications, so it may not apply to complicated pregnancies.
Declared interests
The authors declared no conflict of interest. The study was supported by a grant from Korea University College of Nursing (No. K2313331).
The easy way to misread this
Do not conclude that health-related quality of life steadily declines throughout pregnancy. The pooled overall comparison found no statistically significant difference between the first and second trimesters or between the first and third trimesters, and the trajectory varied by measurement instrument.