{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T01:26:08Z","timestamp":1788225968852,"version":"build-2803163510"},"reference-count":27,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T00:00:00Z","timestamp":1692144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nIntroduction<\/jats:title>\nThe objective of this study is to evaluate the prevalence of nonsevere maternal morbidities (including overall health, domestic and sexual violence, functionality, and mental health) in women during antenatal care in rural versus urban areas. This study aimed to describe the factors that affect women\u2019s health during pregnancy by administration of the WHO\u2019s WOICE 2.0 instrument.<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nThis was a cross sectional study conducted at perinatal care health centers in Morocco (5 in rural and 5 in urban). We recruited n = 257 women in the third trimester of their pregnancy using a questionnaire developed by the WHO to assess maternal morbidity, which includes various instruments that measure different aspects of maternal health. This tool evaluates the functionality and ability to perform daily tasks includes a tool that evaluates mental health, the General Anxiety Disorder 7-item test (GAD-7), and the 9-item Patient Health Questionnaire (PHQ-9), to assess depression. Data on health conditions and socio-demographic characteristics were collected through structured interview, medical record review, and clinical examination. This paper presents descriptive data on the distribution of functioning status among antepartum women.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nIn all, 257 women at a mean age of 30 years were included, and the majority had a partner (98%) and primary education (68.48%). Over one third of the population cannot read. Exposure to violence occurred in 12.23%. Sexual dissatisfaction was reported by 28.20% of antepartum women. Overall, women reported very good and good health (39.69%), and more than third had a medical condition (39.69%). There was an overall rate of anxiety in 83.65%, depression in 43.57%. Based on the \u03c72 test, Fisher exact test, or Kruskal-Wallis test, there was a significant relationship between the distribution of depression (p<0.001) and sexual satisfaction (p<0.01) between urban and rural women.<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nConsidering these results, antepartum depression and anxiety were highly prevalent in our sample and contributed substantially to perceived disability. These serious threats to health must be further investigated and more data are needed to comprehensively quantify the problem in Morocco.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0275882","type":"journal-article","created":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T17:42:35Z","timestamp":1692207755000},"page":"e0275882","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Overall maternal morbidity during pregnancy using the WHO-WOICE tools"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5608-1757","authenticated-orcid":true,"given":"Hanane","family":"Hababa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bouchra","family":"Assarag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,8,16]]},"reference":[{"key":"pone.0275882.ref001","author":"S. Pabon","year":"2020","journal-title":"Overall maternal morbidity during pregnancy identified with the WHO-WOICE instrument"},{"key":"pone.0275882.ref002","first-page":"10","volume":"141","author":"M. Barreix","year":"2018","journal-title":"Standardizing the measurement of maternal morbidity: pilot study results"},{"issue":"1","key":"pone.0275882.ref003","first-page":"1","article-title":"Maternal morbidity","volume":"141","author":"L. Say","year":"2018","journal-title":"time for reflection, recognition, and action"},{"key":"pone.0275882.ref004","first-page":"4","volume":"141","author":"V. Filippi","year":"2018","journal-title":"A new conceptual framework for maternal morbidity"},{"key":"pone.0275882.ref005","first-page":"61","volume":"141","author":"T. Firoz","year":"2018","journal-title":"A framework for healthcare interventions to address maternal morbidity"},{"issue":"1","key":"pone.0275882.ref006","first-page":"1","article-title":"Maternal morbidity measurement tool pilot","volume":"13","author":"L. Say","year":"2016","journal-title":"study protocol"},{"issue":"6","key":"pone.0275882.ref007","first-page":"e013903","article-title":"Consequences of maternal morbidity on health-related functioning","volume":"7","author":"K. Machiyama","year":"2017","journal-title":"a systematic scoping review"},{"key":"pone.0275882.ref008","first-page":"1","volume":"16","author":"D. Chou","year":"2016","journal-title":"Constructing maternal morbidity\u2013towards a standard tool to measure and monitor maternal health beyond mortality"},{"issue":"4","key":"pone.0275882.ref009","first-page":"e0214199","volume":"14","author":"I.L. Lange","year":"2019","journal-title":"What maternal morbidities are and what they mean for women: A thematic analysis of twenty years of qualitative research in low and lower-middle income countries"},{"key":"pone.0275882.ref010","first-page":"55","volume":"141","author":"J.P. Guida","year":"2018","journal-title":"The impact of hypertension, hemorrhage, and other maternal morbidities on functioning in the postpartum period as assessed by the WHODAS 2.0 36\u2010item tool"},{"issue":"1","key":"pone.0275882.ref011","first-page":"357","volume":"21","author":"M.N. Lamus","year":"2021","journal-title":"Giving women WOICE postpartum: prevalence of maternal morbidity in high-risk pregnancies using the WHO-WOICE instrument"},{"issue":"1","key":"pone.0275882.ref012","doi-asserted-by":"crossref","DOI":"10.1186\/s12978-015-0065-0","article-title":"Demographic and obstetric factors affecting women\u2019s sexual functioning during pregnancy","volume":"12","author":"K. Abouzari-Gazafroodi","year":"2015","journal-title":"Reproductive health"},{"key":"pone.0275882.ref013","first-page":"873","article-title":"Sexual activity and sexual dysfunction of women in the perinatal period","volume":"295","author":"S. Wallwiener","year":"2017","journal-title":"a longitudinal study"},{"issue":"5","key":"pone.0275882.ref014","first-page":"S202","article-title":"Sexuality of the woman during pregnancy","volume":"19","author":"R. Boufarguine","year":"2022","journal-title":"Experience of the Tunisian woman"},{"key":"pone.0275882.ref015","first-page":"1873","article-title":"Intimate partner violence during pregnancy","volume":"27","author":"R. Silva","year":"2022","journal-title":"a focus on partner characteristics"},{"issue":"9","key":"pone.0275882.ref016","first-page":"606","article-title":"Williams, The PHQ\u20109","volume":"16","author":"K. Kroenke","year":"2001","journal-title":"validity of a brief depression severity measure"},{"issue":"10","key":"pone.0275882.ref017","first-page":"1092","article-title":"A brief measure for assessing generalized anxiety disorder","volume":"166","author":"R.L. Spitzer","year":"2006","journal-title":"the GAD-7"},{"key":"pone.0275882.ref018","volume-title":"World Health Organization Multi-country Study on Women\u2019s Health and Domestic Violence Against Women: Initial Results on Prevalence, Health Outcomes and Women\u2019s Responses","author":"C. Garc\u00eda-Moreno","year":"2005"},{"issue":"15\u201316","key":"pone.0275882.ref019","first-page":"2417","article-title":"Domestic violence in pregnancy","volume":"26","author":"F.S.J. Almeida","year":"2017","journal-title":"prevalence and characteristics of the pregnant woman"},{"key":"pone.0275882.ref020","first-page":"405","article-title":"Ricci-Cabello, Opinions and experiences of primary healthcare providers regarding violence against women","volume":"33","author":"L. Saletti-Cuesta","year":"2018","journal-title":"a systematic review of qualitative studies"},{"issue":"1","key":"pone.0275882.ref021","first-page":"1","article-title":"Wilson, Intimate partner violence among pregnant women in Kenya","volume":"22","author":"M. Stiller","year":"2022","journal-title":"forms, perpetrators and associations"},{"issue":"6","key":"pone.0275882.ref022","first-page":"1265","volume":"51","author":"A.D. Laksono","year":"2022","journal-title":"Wulandari, Violence against pregnant women in Indonesia"},{"issue":"2","key":"pone.0275882.ref023","first-page":"136","volume":"27","author":"M.L. 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Ginja","year":"2020","journal-title":"a UK-based cross-sectional study"},{"issue":"10","key":"pone.0275882.ref027","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0048396","article-title":"Antepartum Depression and Anxiety Associated with Disability in African Women: Cross-Sectional Results from the CDS Study in Ghana and C\u00f4te d\u2019Ivoire","volume":"7","author":"C. Bindt","year":"2012","journal-title":"Plos one"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0275882","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,16]],"date-time":"2023-08-16T17:43:00Z","timestamp":1692207780000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0275882"}},"subtitle":[],"editor":[{"given":"Aklilu","family":"Habte Hailegebireal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2023,8,16]]},"references-count":27,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2023,8,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0275882","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,16]]}}}