Diagnosed Health Problems, Perceived Health and Attachment to the Fetus in Pregnant Women after Natural vs. Assisted Conception

The study is aimed to explore health and attachment to fetus in pregnant women with natural conception (NC) vs. in-vitro fertilization (IVF). Hypotheses. (1) There are average differences in diagnosed health problems between women with IVF pregnancy and women with NC pregnancy; (2) There are average differences in perceived health between women with IVF pregnancy and women with NC pregnancy; (3) There is a moderate association between diagnosed health problems and perceived health; (4) Women with IVF pregnancy on average report greater attachment to fetus than women with NC pregnancy; (5) Diagnosed health problems are negatively related to attachment to the fetus; and this link is partially mediated by perceived health. Methods. The study was a part of an ongoing prospective longitudinal project in Russia, with the sample including 244 women with NC and 105 women with IVF pregnancy. Data were collected from medical records and questionnaires completed during the first and third trimesters of pregnancy. The measures included perceived health; a detailed measure of reproductive and general health; and a comprehensive measure of attachment to the fetus. Pregnant women completed the questionnaires during the first and third trimesters of pregnancy. In total, 46 questions were related to different health problems. In addition, medical information was obtained from antenatal records stored in the databases of partner clinics. On the bases of combined questionnaire and medical records data, 2 general health indexes were created: Reproductive Health Index (RHI - a measure of reproductive health), Physical Health Index (PHI - a measure of physical health, excluding reproductive). Statistical data analysis was performed with IBM SPSS Statistics 22 software package (descriptive statistics, Chi square test, Mann-Whitney U test, Spearman nonparametric correlation criterion, multiple regression analysis). Data were checked for normal distribution using Kolmogorov-Smirnov criterion. Conclusion. Despite the poorer state of health in terms of reproductive and some somatic indicators, the self-rated health of women with induced pregnancy was not worse than perceived health of women whose pregnancy occurred naturally. Attachment to the fetus was slightly greater for women in the IVF group than in the NC group. Diagnosed and perceived heath was not significantly related to attachment to the fetus.