Pregnancy preferences, reproductive autonomy, and maternal health: A novel prospective study

怀孕偏好、生殖自主权和孕产妇健康:一项新颖的前瞻性研究

基本信息

项目摘要

PROJECT SUMMARY Research linking unintended pregnancy with increased risk of adverse maternal and child health outcomes is fraught with significant conceptual and scientific limitations, including cross-sectional designs, residual confounding, and simplistic, retrospective assessment of pregnancy intentions. A critical gap in our scientific knowledge thus remains: Are the adverse maternal health outcomes associated with unintended pregnancy and childbearing due to unintended pregnancy itself or rather contextual factors that are associated with increased risk of unintended pregnancy? The proposed research is the first to apply state-of-the-art methods and theory to the measurement of pregnancy intentions to rigorously address this long-standing scientific gap. This prospective study follows a cohort of 2,200 non-pregnant women over one year, measuring preferences about a possible pregnancy using a new, robust instrument: the Desire to Avoid Pregnancy (DAP) scale. This validated psychometric scale captures a continuum of cognitive, affective, and practical considerations about pregnancy and childbearing, moving beyond conceptually limited “intending” and “not intending” labels. Participants experiencing incident pregnancies – and a matched subset of non-pregnant women with similar pregnancy preferences – are then followed for an additional three years to measure mental and physical health outcomes during pregnancy and after birth. This innovative design positions us to address three aims. In Aim 1, we will identify the time-varying and invariant contextual factors in women’s lives that shape their preconception pregnancy preferences, such as relationship factors and financial stability, and test how preferences predict incident pregnancy. In Aim 2, among women who experience a new pregnancy, we will examine the relationship between prospectively assessed pregnancy preferences and maternal health outcomes, accounting for temporally important confounding factors (from Aim 1). In Aim 3, we will investigate how the relationship between pregnancy and adverse health outcomes differs by pregnancy preferences. Specifically, with our matched design, we will compare health outcomes among pregnant women to those of women who best represent their counterfactual: women who had similar pregnancy preferences yet who did not experience pregnancy. Thereby, we emulate a hypothetic trial in which women, conditional on confounders, are randomly assigned to pregnancy, allowing us to examine whether the negative health effects of pregnancy are amplified among those who most desire to avoid pregnancy. Achieving these aims will contribute new insights into the health repercussions of unintended pregnancy for women and elucidate the degree to which adverse outcomes stem from the intention status of pregnancies or underlying social and contextual factors. These insights are critical to developing appropriately focused maternal morbidity prevention efforts. Robust data on health consequences of attaining one’s preferred pregnancy outcomes are also needed to inform interventions around contraceptive access and reproductive autonomy.
项目摘要 将意外怀孕与不良母婴健康结果风险增加联系起来的研究 充满了重大的概念和科学的局限性,包括横截面设计,残留的 混淆和简单化,回顾性评估怀孕的意图。我们科学研究中的一个关键空白 因此,知识仍然存在:不良孕产妇健康结果是否与意外怀孕有关 以及由于意外怀孕本身或与之相关的背景因素而导致的生育 增加意外怀孕的风险?拟议的研究是第一次应用最先进的方法 和理论来测量怀孕意图,以严格解决这一长期存在的科学差距。 这项前瞻性研究对2,200名非怀孕妇女进行了为期一年的跟踪调查, 使用一种新的、强大的工具:避免怀孕的愿望(DAP)量表。这 有效心理测量学 量表涵盖了认知、情感和实践方面的连续考虑, 怀孕和生育,超越概念上有限的"有意"和"无意"标签。 经历意外怀孕的参与者-以及具有类似症状的非妊娠女性的匹配子集 怀孕偏好-然后再跟踪三年,以衡量心理和身体健康 怀孕期间和出生后的结果。这一创新设计使我们能够实现三个目标。在aim中 1,我们将确定妇女生活中的时变和不变的背景因素,这些因素塑造了她们的生活。 孕前怀孕偏好,如关系因素和财务稳定性,并测试如何 偏好预测意外怀孕。在目标2中,在经历新怀孕的妇女中,我们将 研究前瞻性评估的妊娠偏好与孕产妇健康之间的关系 结果,考虑时间上重要的混杂因素(来自目标1)。在目标3中,我们将研究 怀孕和不良健康结果之间的关系如何因怀孕偏好而不同。 具体来说,通过我们的配对设计,我们将比较孕妇与 最能代表其反事实的女性:具有相似怀孕偏好的女性, 没有怀孕的经历。因此,我们模仿一个假设的审判,其中妇女,条件是 混杂因素,被随机分配到怀孕,使我们能够检查是否有负面的健康影响, 在那些最希望避免怀孕的人中,怀孕的风险被放大了。实现这些目标将 为意外怀孕对妇女健康的影响提供新的见解,并阐明 不良后果源于怀孕的意向状态或潜在的社会和 背景因素这些见解对于制定适当的重点孕产妇发病率至关重要 预防工作。关于获得自己希望的妊娠结果的健康后果的可靠数据如下: 还需要为有关获得避孕药具和生育自主权的干预措施提供信息。

项目成果

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Corinne H. Rocca其他文献

Associations Among Sociodemographic and Contextual Factors and Youth Pregnancy Preferences
社会人口统计学和背景因素与青少年怀孕偏好之间的关联
  • DOI:
    10.1016/j.jadohealth.2025.03.017
  • 发表时间:
    2025-07-01
  • 期刊:
  • 影响因子:
    4.500
  • 作者:
    Sarah F. Nathan;Susan A. Chapman;Claire D. Brindis;Corinne H. Rocca
  • 通讯作者:
    Corinne H. Rocca
10. Reproductive Autonomy: Supporting Contraceptive Agency for Young People in the Clinic Visit
  • DOI:
    10.1016/j.jadohealth.2023.11.029
  • 发表时间:
    2024-03-01
  • 期刊:
  • 影响因子:
  • 作者:
    Cynthia C. Harper;Kristine Hopkins;Jennifer Yarger;Hannah Hecht;Kristyn Brandi;Alejandra Tello Perez;Isabel Muñoz;Maria Rodriguez;Iris Wong;Corinne H. Rocca
  • 通讯作者:
    Corinne H. Rocca

Corinne H. Rocca的其他文献

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{{ truncateString('Corinne H. Rocca', 18)}}的其他基金

Advancing Innovative Measurement of Pregnancy Preferences with Longitudinal Data
利用纵向数据推进怀孕偏好的创新测量
  • 批准号:
    10444819
  • 财政年份:
    2022
  • 资助金额:
    $ 51.64万
  • 项目类别:
Advancing Innovative Measurement of Pregnancy Preferences with Longitudinal Data
利用纵向数据推进怀孕偏好的创新测量
  • 批准号:
    10709484
  • 财政年份:
    2022
  • 资助金额:
    $ 51.64万
  • 项目类别:
Pregnancy preferences, reproductive autonomy, and maternal health: A novel prospective study
怀孕偏好、生殖自主权和孕产妇健康:一项新颖的前瞻性研究
  • 批准号:
    10420659
  • 财政年份:
    2022
  • 资助金额:
    $ 51.64万
  • 项目类别:

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