Health Literacy and Health-Related Quality of Life Across Late Pregnancy in Women with and Without Gestational Hypertension: A Longitudinal Study in Penang, Malaysia

Gestational hypertension (GH) imposes physiological and psychosocial burdens that reduce maternal well-being. Health literacy (HL) and health-related quality of life (HRQoL) are important factors influencing self-care and perceived health. This study compared HL and HRQoL between pregnant women with and without GH during the second and third trimesters of pregnancy and examined the relationship between them. A prospective longitudinal comparative study was conducted involving 378 pregnant women. HL and HRQoL were assessed during the second and third trimesters using the 12-item Health Literacy Scale (HLS-12) and the 36-Item Short Form Health Survey (SF-36), respectively. Women with GH had lower median HRQoL and HL scores in the second and third trimesters (p < 0.05). Within the GH group, HRQoL declined from 80 (65–90) to 55 (40–65) in the physical functioning domain, with similar reductions in role limitation and general health domains. The percentage of women with low or moderate HRQoL increased markedly in the GH group (p < 0.001). HL differed significantly between groups; women with GH were more frequently classified as having inadequate or problematic HL (p < 0.001). Compared to normotensive women, pregnant women with GH have lower HL and HRQoL during the second and third trimesters. The two variables were moderately correlated. There is a further need to assess HL and HRQoL in women with high-risk pregnancies and to implement effective strategies to improve the affected domains.