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Association Between Pregnancy Intention and Reproductive-health Related Behaviors Before and After Pregnancy Recognition, National Birth Defects Prevention Study, 1997–2002

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Abstract

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.

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References

  1. Kochanek, K. D., Murphy, S. L., Anderson, R. N., & Scott, C. (2004). Deaths: Final data for 2002. National Vital Statistics Reports, 53, 1–115.

    PubMed  Google Scholar 

  2. Callaghan, W. M., MacDorman, M. F., Rasmussen, S. A., Qin, C., & Lackritz, E. M. (2006). The contribution of preterm birth to infant mortality rates in the United States. Pediatrics, 118, 1566–1573. doi:10.1542/peds.2006-0860.

    Article  PubMed  Google Scholar 

  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.

  4. Ogunyemi, D., & Hernandez-Loera, G. E. (2004). The impact of antenatal cocaine on maternal characteristics and neonatal outcomes. The Journal of Maternal-Fetal & Neonatal Medicine, 15, 253–259.

    Article  CAS  Google Scholar 

  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 

  7. Li, D. K., Janevic, T., Odouli, R., & Liu, L. (2003). Hot tub use during pregnancy and the risk of miscarriage [see comment]. American Journal of Epidemiology, 158, 931–937.

    Article  PubMed  Google Scholar 

  8. Milunsky, A., Ulcickas, M., Rothman, K. J., Willett, W., Jick, S. S., & Jick, H. (1992). Maternal heat exposure and neural tube defects. JAMA, 268, 882–885.

    Article  CAS  PubMed  Google Scholar 

  9. Schempf, A. H. (2007). Illicit drug use and neonatal outcomes: a critical review. Obstetrical and Gynecological Survey, 62, 749–757.

    Article  PubMed  Google Scholar 

  10. Larivaara, P., Hartikainen, A. L., & Rantakallio, P. (1996). Use of psychotropic drugs and pregnancy outcome. Journal of Clinical Epidemiology, 49, 1309–1313.

    Article  CAS  PubMed  Google Scholar 

  11. Tolstrup, J. S., Kjaer, S. K., Munk, C., Madsen, L. B., Ottesen, B., Bergholt, T., et al. (2003). Does caffeine and alcohol intake before pregnancy predict the occurrence of spontaneous abortion? Human Reproduction, 18, 2704–2710.

    Article  CAS  PubMed  Google Scholar 

  12. Care Study Group. (2008). Maternal caffeine intake during pregnancy and risk of fetal growth restriction: a large prospective observational study. BMJ, 337, a2332.

    Article  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.

  16. Finer, L. B., & Henshaw, S. K. (2006). Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspectives on Sexual and Reproductive Health, 38, 90–96.

    Article  PubMed  Google Scholar 

  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 

  18. Santelli, J., Rochat, R., Hatfield-Timajchy, K., Gilbert, B. C., Curtis, K., Cabral, R., et al. (2003). The measurement and meaning of unintended pregnancy. Perspectives on sexual and reproductive health, 35, 94–101.

    Article  PubMed  Google Scholar 

  19. Naimi, T. S., Lipscomb, L. E., Brewer, R. D., & Gilbert, B. C. (2003). Binge drinking in the preconception period and the risk of unintended pregnancy: implications for women and their children. Pediatrics, 111, 1136–1141.

    PubMed  Google Scholar 

  20. Morin, P., De Wals, P., Noiseux, M., Niyonsenga, T., St-Cyr-Tribble, D., & Tremblay, C. (2002). Pregnancy planning and folic acid supplement use: Results from a survey in Quebec. Preventive Medicine, 35, 143–149.

    Article  PubMed  Google Scholar 

  21. Rosenberg, K. D., Gelow, J. M., & Sandoval, A. P. (2003). Pregnancy intendedness and the use of periconceptional folic acid. Pediatrics, 111, 1142–1145.

    PubMed  Google Scholar 

  22. Than, L. C., Honein, M. A., Watkins, M. L., Yoon, P. W., Daniel, K. L., & Correa, A. (2005). Intent to become pregnant as a predictor of exposures during pregnancy: Is there a relation? Journal of Reproductive Medicine, 50, 389–396.

    PubMed  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 

  24. Yoon, P. W., Rasmussen, S. A., Lynberg, M. C., Moore, C. A., Anderka, M., Carmichael, S. L., et al. (2001). The National Birth Defects Prevention Study. Public Health Reports, 116(Suppl 1), 32–40.

    Article  PubMed  Google Scholar 

  25. Browne, M. L., Bell, E. M., Druschel, C. M., Gensburg, L. J., Mitchell, A. A., Lin, A. E., et al. (2007). Maternal caffeine consumption and risk of cardiovascular malformations. Birth Defects Research. Part A, Clinical and Molecular Teratology, 79, 533–543.

    Article  CAS  PubMed  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 

  27. Mohllajee, A. P., Curtis, K. M., Morrow, B., & Marchbanks, P. A. (2007). Pregnancy intention and its relationship to birth and maternal outcomes. Obstetrics and Gynecology, 109, 678–686.

    CAS  PubMed  Google Scholar 

  28. Hutchison, K. E., Stevens, V. M., & Collins, F. L. (1996). Cigarette smoking and the intention to quit among pregnant smokers. Journal of Behavioral Medicine, 19, 307–316.

    Article  CAS  PubMed  Google Scholar 

  29. Quinn, V. P., Mullen, P. D., & Ershoff, D. H. (1991). Women who stop smoking spontaneously prior to prenatal care and predictors of relapse before delivery. Addictive Behaviors, 16, 29–40.

    Article  CAS  PubMed  Google Scholar 

  30. Ockene, J., Ma, Y., Zapka, J., Pbert, L., Valentine Goins, K., & Stoddard, A. (2002). Spontaneous cessation of smoking and alcohol use among low-income pregnant women. American Journal of Preventive Medicine, 23, 150–159.

    Article  PubMed  Google Scholar 

  31. Yu, S. M., Park, C. H., & Schwalberg, R. H. (2002). Factors associated with smoking cessation among U.S. pregnant women. Maternal and Child Health Journal, 6, 89–97.

    Article  PubMed  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 

  33. Hogue, C. J., & Vasquez, C. (2002). Toward a strategic approach for reducing disparities in infant mortality. American Journal of Public Health, 92, 552–556.

    Article  PubMed  Google Scholar 

  34. Collier, S. A., & Hogue, C. J. (2006). Modifiable risk factors for low birth weight and their effect on cerebral palsy and mental retardation. Maternal and Child Health Journal, 11, 65–71.

    Article  Google Scholar 

  35. Hack, M., Taylor, H. G., Klein, N., & Mercuri-Minich, N. (2000). Functional limitations and special health care needs of 10- to 14-year-old children weighing less than 750 grams at birth. Pediatrics, 106, 554–560.

    Article  CAS  PubMed  Google Scholar 

  36. Hack, M., Youngstrom, E. A., Cartar, L., Schluchter, M., Taylor, H. G., Flannery, D., et al. (2004). Behavioral outcomes and evidence of psychopathology among very low birth weight infants at age 20 years. Pediatrics, 114, 932–940.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors are grateful to the participating families, scientists, and staff of the National Birth Defects Prevention Study. In addition, the authors wish to thank Sarah Collier for her assistance with SAS programming.

Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

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Correspondence to Mary Dott.

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Dott, M., Rasmussen, S.A., Hogue, C.J. et al. Association Between Pregnancy Intention and Reproductive-health Related Behaviors Before and After Pregnancy Recognition, National Birth Defects Prevention Study, 1997–2002. Matern Child Health J 14, 373–381 (2010). https://doi.org/10.1007/s10995-009-0458-1

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