怀孕意向与婴儿、妊娠、母亲和幼儿结局的关系:来自阿拉斯加、密苏里和俄克拉何马州出生的证据。

IF 3.4 2区 医学 Q1 DEMOGRAPHY Perspectives on Sexual and Reproductive Health Pub Date : 2023-03-01 DOI:10.1363/psrh.12222
Erica Hobby, Nicholas D E Mark, Alison Gemmill, Sarah K Cowan
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引用次数: 0

摘要

目标:美国的大部分生殖保健政策侧重于使妇女能够有计划地怀孕。调查怀孕意图与母亲和儿童近期和长期不良后果之间的关联是由于意图还是母亲的人口统计数据,为旨在改善孕产妇和儿童结局的政策制定者提供了有价值的背景。方法:我们调查了妊娠意向与妊娠、婴儿、幼儿和产妇结局之间的关系,使用的数据来自妊娠风险评估监测系统调查,在孩子出生后2-8个月进行,并在三个州(阿拉斯加、密苏里和俄克拉荷马州)进行随访调查,在2-3岁时进行。我们使用反向倾向权重的逻辑回归来衡量关联,考虑潜在的混杂因素。结果:反向倾向加权后,妊娠意向与孕产妇不良妊娠行为相关,但与大多数婴儿结局无关。报告意外怀孕的母亲与孩子接受发育迟缓诊断的几率增加有关。在那些在怀孕前没有报告抑郁的母亲中,意外怀孕的母亲更有可能经历持续的抑郁,而怀孕时间不正确的母亲在产后或随访期间更有可能经历抑郁。结论:我们的研究结果表明,与社会经济劣势相比,怀孕意愿对孕产妇和儿童福祉的影响较小,这表明将政策重新定位于社会条件和生殖自主将更好地服务于个人和人口健康。
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Pregnancy intentions' relationship with infant, pregnancy, maternal, and early childhood outcomes: Evidence from births in Alaska, Missouri, and Oklahoma.

Objectives: Much of reproductive health care policy in the United States focuses on enabling women to have intended pregnancies. Investigating whether the association between pregnancy intention and adverse outcomes for mothers and children in the immediate and longer term is due to intention or a mother's demographics provides valuable context for policy makers aiming to improve maternal and child outcomes.

Methods: We investigated relationships between pregnancy intention and pregnancy, infant, early childhood, and maternal outcomes using data from the Pregnancy Risk Assessment Monitoring System survey, conducted 2-8 months after the child's birth, and follow-up surveys from three states (Alaska, Missouri, and Oklahoma), administered at age 2-3 years old. We used logistic regressions with inverse propensity weights to measure associations, accounting for potential confounding factors.

Results: After inverse propensity weighting, pregnancy intention was associated with adverse maternal pregnancy behaviors but not most infant outcomes. Mothers who reported an unwanted pregnancy were associated with increased odds of the child receiving a developmental delay diagnosis. Among those who did not report depression prior to pregnancy, mothers with unwanted pregnancies were more likely to experience persistent depression, and mothers with pregnancies mistimed by two or more years had a higher likelihood of experiencing depression postpartum or in the follow up period.

Conclusions: Our findings suggest that pregnancy intention is less consequential for maternal and child well-being than socio-economic disadvantage, suggesting that re-orienting policy toward social conditions and reproductive autonomy will serve better individual and population health.

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来源期刊
CiteScore
5.10
自引率
3.40%
发文量
24
期刊介绍: Perspectives on Sexual and Reproductive Health provides the latest peer-reviewed, policy-relevant research and analysis on sexual and reproductive health and rights in the United States and other developed countries. For more than four decades, Perspectives has offered unique insights into how reproductive health issues relate to one another; how they are affected by policies and programs; and their implications for individuals and societies. Published four times a year, Perspectives on Sexual and Reproductive Health includes original research, special reports and commentaries on the latest developments in the field of sexual and reproductive health, as well as staff-written summaries of recent findings in the field.
期刊最新文献
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