Health-Related Quality of Life in Pregnancy Associated with Psychological Distress

<i>Background and Objectives</i>: Pregnancy is associated with profound physical and psychological changes in a woman's life. Psychological distress and medical comorbidities during pregnancy remain under recognized despite their potential impact on maternal well-being. This study aimed to examine the associations between psychological distress, physical and mental components of health-related quality of life (HRQoL), lifestyle factors (alcohol and tobacco use), and the presence of medical comorbidities in pregnant women. <i>Materials and Methods:</i> A cross-sectional study was conducted among pregnant women in the second and third trimesters admitted to a tertiary obstetrics and gynecology center in Romania. Psychological distress was assessed using the Symptom Checklist-90-Revised (SCL-90-R) Global Severity Index (GSI), while health-related quality of life (HRQoL) was evaluated with the Short Form Health Survey-36 items (SF-36) physical (PCS) and mental (MCS) Component Summary scores. Alcohol and tobacco use were assessed using Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and the Fagerström Test for Nicotine Dependence (FTND). Nonparametric tests were used for correlation and group-comparison analyses. <i>Results</i>: Among the 337 valid answers, higher psychological distress was significantly associated with lower physical (R = -0.16, <i>p</i> < 0.01) and mental (R = -0.26, <i>p</i> < 0.01) HRQoL. Pregnant women with medical comorbidities reported higher psychological distress and poorer physical HRQoL compared with those without comorbidities, while mental HRQoL did not differ significantly. Alcohol and tobacco use were not significantly associated with HRQoL or psychological distress. <i>Conclusions</i>: Psychological distress is a central factor associated with both physical and mental quality of life during pregnancy. Integrating routine mental health screening into antenatal care, particularly for women with medical comorbidities, may improve maternal well-being and support better pregnancy outcomes.