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Demographic Characteristics, Health Behaviors Before and During Pregnancy, and Pregnancy and Birth Outcomes in Mothers with Different Pregnancy Planning Status

Prevention Science volume 17, pages 960–969 (2016)Cite this article

Abstract

Studies on pregnancy intentions and their consequences have yielded mixed results. Here, we comprehensively analyzed the maternal characteristics, health behaviors before and during pregnancy, as well as pregnancy and birth outcomes, across three different pregnancy planning status in 861 women participating in an ongoing Asian mother-offspring cohort study. At 26–28 weeks’ gestation, the women’s intention and enthusiasm toward their pregnancy were used to classify their pregnancy into planned or unplanned, and unplanned pregnancy was further subdivided into mistimed or unintended. Data on maternal characteristics, health behaviors, and pregnancy outcomes up to that stage were recorded. After delivery, birth outcomes of the offspring were recorded. Linear and logistic regression analyses were performed. Overall, 56 % had a planned pregnancy, 39 % mistimed, and 5 % unintended. Compared to women who planned their pregnancy, women with mistimed pregnancy had higher body mass index and were more likely to have cigarette smoke exposure and less likely to have folic acid supplementation. At 26–28 weeks’ gestation, unintended pregnancy was associated with increased anxiety. Neonates of mistimed pregnancy had shorter birth length compared to those of planned pregnancy, even after adjustment for maternal baseline demographics. These findings suggest that mothers who did not plan their pregnancy had less desirable characteristics or health behaviors before and during pregnancy and poorer pregnancy and birth outcomes. Shorter birth length in mistimed pregnancy may be attributed to maternal behaviors before or in the early stages of pregnancy, therefore highlighting the importance of preconception health promotion and screening for women of child-bearing age.

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Acknowledgments

The authors would like to thank the study subjects and their families for their participation.

The GUSTO study group includes Allan Sheppard, Amutha Chinnadurai, Anne Eng Neo Goh, Anne Rifkin-Graboi, Anqi Qiu, Arijit Biswas, Bee Wah Lee, Birit F.P. Broekman, Boon Long Quah, Borys Shuter, Chai Kiat Chng, Cheryl Ngo, Choon Looi Bong, Christiani Jeyakumar Henry, Cornelia Yin Ing Chee, Yam Thiam Daniel Goh, Doris Fok, George Seow Heong Yeo, Helen Chen, Hugo P S van Bever, Iliana Magiati, Inez Bik Yun Wong, Ivy Yee-Man Lau, Jeevesh Kapur, Jenny L. Richmond, Joanna D. Holbrook, Joshua J. Gooley, Kok Hian Tan, Krishnamoorthy Niduvaje, Leher Singh, Lin Lin Su, Lourdes Mary Daniel, Lynette Pei-Chi Shek, Marielle V. Fortier, Mark Hanson, Mary Foong-Fong Chong, Mary Rauff, Mei Chien Chua, Michael Meaney, Mya Thway Tint, Neerja Karnani, Oon Hoe Teoh, P. C. Wong, Pratibha Agarwal, Rob M. van Dam, Salome A. Rebello, Shang Chee Chong, Shirong Cai, Shu-E Soh, Sok Bee Lim, Chin-Ying Stephen Hsu, Victor Samuel Rajadurai, Walter Stunkel, Wee Meng Han, Wei Wei Pang, and Yiong Huak Chan.

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Author notes

    Affiliations

    1. Department of Paediatrics, KK Women’s and Children’s Hospital, 100, Bukit Timah Road, Singapore, 229899, Singapore

      Tuck Seng Cheng, Fabian Yap & Ngee Lek

    2. KK Research Centre, KK Women’s and Children’s Hospital, Singapore, Singapore

      See Ling Loy & Jerry Kok Yen Chan

    3. Duke-NUS Medical School, Singapore, Singapore

      See Ling Loy, Fabian Yap, Jerry Kok Yen Chan & Ngee Lek

    4. Center for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore

      Yin Bun Cheung

    5. Tampere Center for Child Health Research, University of Tampere and Tampere University Hospital, Tampere, Finland

      Yin Bun Cheung

    6. MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK

      Keith M. Godfrey

    7. NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK

      Keith M. Godfrey

    8. Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore

      Peter D. Gluckman & Yung Seng Lee

    9. Liggins Institute, University of Auckland, Auckland, New Zealand

      Peter D. Gluckman

    10. Department of Maternal Foetal Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore

      Kenneth Kwek

    11. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

      Seang Mei Saw

    12. Department of Obstetrics and Gynaecology, Yong Loo Ling School of Medicine, National University of Singapore, Singapore, Singapore

      Yap-Seng Chong

    13. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

      Yung Seng Lee

    14. Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore

      Jerry Kok Yen Chan

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    1. Tuck Seng Cheng
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    2. See Ling Loy
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    5. Peter D. Gluckman
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    6. Kenneth Kwek
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    7. Seang Mei Saw
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    8. Yap-Seng Chong
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    9. Yung Seng Lee
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    on behalf of the GUSTO study group

    Corresponding author

    Correspondence to Ngee Lek.

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    Funding

    This study was supported by the Singapore National Research Foundation under its Translational and Clinical Research (TCR) Flagship Program and administered by the Singapore Ministry of Health’s National Medical Research Council (NMRC), Singapore—NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014. Additional funding is provided by the Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore. KMG is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre and by the European Union’s Seventh Framework Program (FP7/2007-2013), project EarlyNutrition under grant agreement n289346. JKYC received salary support from the Ministry of Health’s National Medical Research Council, Singapore (NMRC/CSA/043/2012). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.

    Conflicts of Interest

    Peter D. Gluckman, Keith M. Godfrey, Yung Seng Lee, and Yap-Seng Chong have received reimbursement for speaking at conferences sponsored by companies selling nutritional products. Peter D. Gluckman, Keith M. Godfrey, and Yap-Seng Chong are part of an academic consortium that has received research funding from Abbott Nutrition, Nestle and Danone. Other authors declared no conflict of interest.

    Ethical Approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

    Informed Consent

    Informed consent was obtained from all individual participants included in the study.

    Additional information

    Tuck Seng Cheng and See Ling Loy contributed equally to this work.

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    Cheng, T.S., Loy, S.L., Cheung, Y.B. et al. Demographic Characteristics, Health Behaviors Before and During Pregnancy, and Pregnancy and Birth Outcomes in Mothers with Different Pregnancy Planning Status. Prev Sci 17, 960–969 (2016). https://doi.org/10.1007/s11121-016-0694-8

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    • DOI: https://doi.org/10.1007/s11121-016-0694-8

    Keywords

    • Pregnancy
    • Family planning· maternal health behavior
    • Neonatal outcome