Health Utility Values and Influencing Factors Among Pregnant and Postpartum Women in Rural Yunnan Province, China

Xinping Wang,1,* Rui Deng,1,* Zhongting Yang,1 Rui Liao,2 Yan Xiao,3 Chaofang Yan,1 Feng Jiao,1 Yuan Huang1 1School of Public Health/ Yunnan Provincial Key Laboratory of Public Health and Biosafety/ Yunnan Provincial Key Laboratory of Cross-Border Infectious Disease Prevention and New Drug Development, Kunming Medical University, Kunming, Yunnan, People’s Republic of China; 2Library Kunming Medical University, Kunming, Yunnan, People’s Republic of China; 3Foreign Languages Department, Kunming Medical University, Kunming, Yunnan, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yuan Huang, School of Public Health/ Yunnan Provincial Key Laboratory of Public Health and Biosafety/ Yunnan Provincial Key Laboratory of Cross-Border Infectious Disease Prevention and New Drug Development, Kunming Medical University, Kunming, Yunnan, People’s Republic of China, Email [email protected] Feng Jiao, School of Public Health/ Yunnan Provincial Key Laboratory of Public Health and Biosafety/ Yunnan Provincial Key Laboratory of Cross-Border Infectious Disease Prevention and New Drug Development, Kunming Medical University, Kunming, Yunnan, People’s Republic of China, Email [email protected]: Health utility values (HUVs) are quantifiable metrics used to assess health-related quality of life and reflect individuals’ overall physical, psychological, and social well-being. This study measured HUVs using the the five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) among women in rural Yunnan, China, and identify their determinants to inform targeted interventions for improving maternal quality of life and promoting infant development in resource-limited settings.Patients and Methods: A cross-sectional study was conducted in May 2022 in a rural Yunnan Province, China, enrolling pregnant and postpartum women (within one year after delivery) across six reproductive stages, with a target sample of 50~100 per stage. The Tobit regression model was utilized to analyze the factors influencing the HUVs of pregnant and postpartum women.Results: The analysis included 1,177 valid questionnaires (response rate 96.7%). The HUVs of pregnant and postpartum women in Yunnan ranged from 0.057 to 1.000, with a mean of 0.955 (SD = 0.102). This mean is somewhat lower than the HVUs recently reported in Chinese adults under 40, suggesting a potential decline in health-related quality of life during pregnancy and postpartum period. Depressive symptoms were prevalent in 22.9% of participants, with greater severity inversely associated with HUVs, indicating that mental health burdens may substantially impair health-related quality of life during this critical phase. Tobit regression analyses confirmed perinatal depressive symptoms as a significant predictor of reduced HUVs across all reproductive stages. Additional key factors influencing HUVs included social support, health behaviors, breastfeeding difficulties, postpartum recovery challenges, and infant health status.Conclusion: This study provides novel quantitative evidence on health-related quality of life among pregnant and postpartum women in rural China. The findings demonstrate the impact of psychosocial and behavioral factors on maternal health outcomes. These insights can inform the development of targeted interventions and guide health policy decisions aimed at improving maternal and child well-being in resource-limited settings.Keywords: pregnant and postpartum women, health utility values, Rural China, depressive symptoms, influencing factors