Association Between Pregnancy Intention and Reproductive-health Related Behaviors Before and After Pregnancy Recognition, National Birth Defects Prevention Study, 1997–2002
Objectives Given that approximately half of all pregnancies in the United States are unplanned, the authors sought to understand the relation between pregnancy intention and health behaviors. Methods Mothers of live-born infants without major birth defects were interviewed as part of the National Birth Defects Prevention Study. The interview assessed pregnancy intention as well as exposures to vitamins, alcohol, tobacco, illicit drugs, occupational hazards, exogenous heat (e.g., hot tubs and saunas) and caffeine. Crude odds ratios and 95% confidence intervals were calculated and stratified analyses were performed to assess interaction. Multiple logistic regression was used to calculate adjusted odds ratios. Results Both before and after the diagnosis of pregnancy, women with unintended pregnancies were more likely to use illicit drugs, smoke, be exposed to environmental smoke, and not take folic acid or multivitamins. The degree to which women altered behaviors after they realized they were pregnant was also associated with their pregnancy intention status. For certain behaviors, maternal age or parity altered the association between pregnancy intention and changing behaviors after awareness of pregnancy. Conclusion Pregnancy intention status is a key determinant of pregnancy-related behavior. To improve reproductive outcomes, preconceptional and prenatal programs should consider a woman’s desire for pregnancy.
KeywordsPregnancy Unplanned pregnancy Unwanted pregnancy Preconception care Prenatal care
- 3.CDC. (2004). Surgeon general’s report—the health consequences of smoking. Accessed June 28, 2008 from http://www.cdc.gov/tobacco/data_statistics/sgr/sgr_2004/chapters.htm.
- 5.Cunningham, F. G., Hauth, J. C., Leveno, K. J., Gilstrap, L., Bloom, S. L., & Wenstrom, K. D. (Eds.). (2005). Williams obstetrics (22nd ed.). New York: McGraw-Hill.Google Scholar
- 6.Centers for Disease Control and Prevention. (1992). Recommendations for the use of folic acid to reduce the number of cases of spina bifida and other neural tube defects. MMWR Recommendations and Reports, 41, 1–7.Google Scholar
- 13.Weng, W., Odouli, R., & De-Kun, L. (2008). Maternal caffeine consumption during pregnancy and the risk of miscarriage: a prospective cohort study. American Journal of Obstetrics and Gynecology, 198, 279.e1–279.e8.Google Scholar
- 14.March of Dimes. Caffeine. Accessed February 20, 2008 from http://www.marchofdimes.com/pnhec/159_816.asp.
- 15.Centers for Disease Control and Prevention. (2008). ABC’s of health pregnancy. Accessed February 20, 2008 from http://www.cdc.gov/ncbddd/bd/abc.htm.
- 17.Beck, L. F., Morrow, B., Lipscomb, L. E., Johnson, C. H., Gaffield, M. E., Rogers, M., et al. (2002). Prevalence of selected maternal behaviors and experiences—Pregnancy Risk Assessment Monitoring System (PRAMS), 1999. MMWR Surveillance Summaries, 51(SS-2), 1–27.Google Scholar
- 23.Centers for Disease Control and Prevention. (2006). Recommendations to improve preconception health and health care—United States. A report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR Recommendation and Reports, 55(RR-06), 1–23.Google Scholar
- 26.Centers for Disease Control and Prevention. (2006). Monitoring progress toward achieving Maternal and Infant Healthy People 2010 objectives-19 states, Pregnancy Risk Assessment Monitoring System (PRAMS), 2000–2003. MMWR Surveillance Summaries, 55(SS-9), 1–11.Google Scholar
- 32.US Department of Health and Human Services. (2000). Healthy people 2010, 2nd ed. With understanding and improving health and objectives for improving health (Vol. 2). Washington, DC: US Department of Health and Human Services.Google Scholar