Women's health in early pregnancy: Findings from an Australian nulliparous cohort study

Background: Much is known about severe maternal morbidity during pregnancy, but there has been little attention paid to the impact of pregnancy itself on women's general health and well-being. Aim: To investigate women's general health and well-being in early pregnancy and examine the relationship between maternal age and women's physical and mental health. Method: Cross-sectional analysis of baseline data from a multicentre, prospective nulliparous pregnancy cohort study. The baseline questionnaire included the SF-36 health status measure and individual items assessing a range of common maternal health issues. Results: A total of 1507 eligible women returned baseline questionnaires in early pregnancy (mean gestation 15 weeks, range 6-24 weeks) ranging from 18 to 49 years of age (mean age 30.1 years). Study participants reported significantly poorer health compared with age and gender-standardised population means on all SF-36 scales except general health. Two-thirds of women (68%) reported three or more health issues, the most common being exhaustion (87%), nausea (64%), back pain (46%), constipation (44%) and severe headaches/migraines (30%). Younger women (18-24 years) had significantly lower SF-36 scores (poorer self perceived health) compared with women >= 35 (P < 0.03). After adjusting for socio-demographic factors, maternal age remained significantly positively associated with women's mental and physical component scores. Younger women reported significantly more health issues than women >= 35 (4.39 and 3.27, mean difference = 1.12, 95% CI 0.75-1.79, P < 0.001). Conclusions: Common pregnancy symptoms have a marked impact on women's physical and mental health in early pregnancy, with the greatest impact apparent for younger women.