Postpartum Quality of Life and Its Associated Factors of Women in Punjab, Pakistan

Abstract

Background: Postpartum quality of life (QOL) is an essential yet often overlooked component of maternal health, reflecting physical, psychological, social, and environmental wellbeing. In low- and middle-income countries, including Pakistan, high maternal morbidity and a substantial prevalence of postpartum depression contribute to compromised outcomes, yet systematic evidence on QOL remains limited. Understanding the determinants of maternal wellbeing in this context is critical for designing holistic healthcare interventions. Objective: This study aimed to assess postpartum quality of life and depression among women in Punjab, Pakistan, and to examine the association between QOL and demographic and clinical factors. Methods: A cross-sectional community-based survey was conducted among 310 postpartum women in three districts of Punjab between September 2024 and February 2025. Data were collected using a structured questionnaire incorporating socio-demographic and obstetric variables, the World Bank–Health-Related Quality of Life (WB-HRQOL) scale, and the Edinburgh Postnatal Depression Scale (EPDS). Statistical analyses included descriptive measures, bivariate comparisons, and multivariable regression adjusting for key covariates. Results: Women reported moderate to high overall QOL (mean 3.59, SD 0.64), with highest scores in environmental and physical domains and lowest in social engagement. Postpartum depression was prevalent in 65.8% and emerged as the strongest predictor of reduced QOL (β = –0.74, p<0.001), while adequate antenatal care was protective (β = +0.21, p=0.015). Conclusion: Despite favorable physical health perceptions, postpartum women in Punjab face high depression rates that markedly impair psychological and social wellbeing. Integrating depression screening, improving antenatal care, and strengthening social support should be prioritized in maternal health strategies.