Self-rated health in Swedish pregnant women: a comprehensive population register study
Abstract Background/Aims Sociodemographic factors are associated with perceived overall health status or ‘self-rated health’. However, research using data from the comprehensive population register in Sweden to examine self-rated health in pregnant women is limited. This study aimed to examine sociodemographic factors associated with self-rated health before, during and after pregnancy in low-risk pregnant women, based on comprehensive population register data in Sweden. Methods This was a retrospective analysis of the Swedish pregnancy register (Graviditets registret). Data from 167 523 women were tested with group comparisons and ordinal regression analyses. Results Women between the ages of 25 and 29 years and primiparas were less likely to self-rate their health lower. Women born outside Scandinavia, those whose education did not reach university level, jobseekers, those on parental leave and students were more likely to report lower self-rated health. Women with risky behaviours, such as alcohol consumption and those who smoked and/or snuffed were more likely to report lower self-rated health. Conclusions The findings indicate that preventive and health promoting actions in the midwifery profession should build on awareness of possible associated sociodemographic factors.
Keywords Self-rated health | Ordinal regression | Maternal healthcare
Atika Khalaf The PRO-CARE Group, Faculty of Health Science, Kristianstad University, Sweden; College of Nursing, Sultan Qaboos University, Muscat, Oman email@example.com Marianne Johansson Academy of Care, Work Life and Social Welfare, University of Borås, Sweden Rania Mahmoud Abdel Ghani Assistant Professor of Maternal and Newborn Health Nursing, Faculty of Nursing, Cairo University, Egypt Pernilla Ny Faculty of Medicine, Lund University, Lund, Sweden
The right to functional sexual and reproductive health includes the right to adequate perinatal care.The World Health Organization (WHO, 2020) has addressed reproductive health as the reproductive processes, functions, and system at all stages of life. Reproductive health rights mean women have the right to access healthcare centers that can facilitate safe pregnancy and childbirth.
Several studies have shown that self-rated health has a strong association with mortality, and this is not related to a known background disease (McFadden et al, 2009). These findings suggest that a self-rated health assessment is a valuable source of information regarding subjective health status.
Although there are many benefits to Swedish maternal healthcare, which influences the self-rated health of pregnant women, there are many factors that influence self-rated health, including physical and emotional symptoms of pregnancy (Schytt and Waldenström, 2007; Schytt and Hildingsson, 2011; Henderson and Redshaw, 2013). In general populations, factors known to be associated with self-rated health include gender, income, education, employment status, culture and health behaviors (Layes et al, 2012).
In pregnant women, reported factors associated with poorer self-rated health include psychological stress, high body mass index and past smoking (Christian et al, 2013). Immigrants and foreign-born women of reproductive age have also been shown to report lower self-rated health in the Swedish population (Eurenius et al, 2011; Henriksson et al, 2020), the Canadian population (Mechakra-Tahiri et al, 2007) and women from the Netherlands (Schoevers et al, 2009).
The importance of studying self-rated health cannot be over-emphasised, considering that it can predict future morbidity in women after childbirth (Cheng and Li, 2008) and early feeding difficulties (Webb, 2018). It is important that women are given the chance to express, prioritise and evaluate different aspects of their health, including their overall health, as it gives an insightful picture of women’s views (Layes et al, 2012).
British Journal of Midwifery, June 2022, Vol 30, No 6