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. 2010 May;14(3):373-81. doi: 10.1007/s10995-009-0458-1. Epub 2009 Feb 28.

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.

MeSH terms

  • Case-Control Studies
  • Congenital Abnormalities / epidemiology
  • Congenital Abnormalities / etiology
  • Congenital Abnormalities / prevention & control*
  • Female
  • Health Behavior*
  • Humans
  • Intention*
  • Logistic Models
  • Maternal Age
  • Maternal Exposure / adverse effects
  • Maternal Exposure / prevention & control
  • Maternal Exposure / statistics & numerical data
  • Parity
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / psychology
  • Pregnancy Tests / psychology*
  • Pregnancy, Unplanned / psychology
  • Pregnancy, Unwanted / psychology
  • Pregnant Women / psychology*
  • Reproductive Medicine*
  • Self Care / methods
  • Self Care / psychology
  • Self Care / statistics & numerical data
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Smoking / psychology
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / psychology
  • Surveys and Questionnaires
  • United States / epidemiology
  • Vitamins / therapeutic use

Substances

  • Vitamins