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October 2018, Volume 68, Issue 10

Letter to the Editor

Comments on Bushra Gul et al (J Pak Med Assoc. 68: 872-875, 2018) Impact of social support for expecting mothers in association with health related quality of life

Ayesha Afridi  ( Bahria University Medical and Dental College, Karachi )

-The article "Social support and health related quality of life among pregnant women" is very important issue in Pakistan on which Bushra Gul and colleagues casted light upon with some interesting findings and relations.1 My point is that demographics should include the family system too, either living separately with husband or in joint family system. Pakistani culture is mostly joint family system in which pregnant females can have a lot more physical and psychological liabilities. Previous studies shows that prevalence of depression and anxiety are more frequently reported in developing countries along with low social status as compare to developed countries. Association of these symptoms is also strong in first trimester due to hormonal changes in the body leading to dizziness, nausea, vomiting and fatigue.2 Bushra Gul reported that majority of their sample were women in their first trimester with decrease in HRQoL which can be justified by these symptoms.1 Pregnancy can be source of bliss and gratification, on the other hand this is whole transition leading to new roles and responsibilities which can be difficult to deal with, especially in the absence of support from friends, family and whole living environment.3 Low health related quality of life can negatively affect the health of developing fetus, ultimately leads to miscarriages, pre term births, still births and different neurological conditions which can have impact on cognitive abilities of child.4 The awareness about the positive impact of social support should be given to spouse and other close family members of the pregnant females by their health care provider to avoid the dissolute consequences.

Disclaimer: None to declare.
Conflict of Interest: None to declare.
Funding Sources: None to declare.


1. Bushra Gul, M.A.Riaz, Naila Batool, Humaira Yasmin, Muhammad Naveed Riaz, Social support and health related quality of life among pregnant women. J Pak Med Assoc 2018; 68: 872-5.
2. Bödecs T, et al. Prevalence and psychosocial background of anxiety and depression emerging during the first trimester of pregnancy: data from a Hungarian population-based sample. Psychiatria Danubina, 2013; 25: 0-358.
3. Angley M, et al. Social support, family functioning and parenting competence in adolescent parents. Maternal and Child Health Journal, 2015; 19: 67-73.

4. Waqas A, et al. Psychosocial factors of antenatal anxiety and depression in Pakistan: is social support a mediator? PLoS ONE, 2015; 10: e0116510.

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: