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      Pregnancy context and women’s health-related quality of life

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          Abstract

          OBJECTIVE

          To quantify the association of pregnancy context and health-related quality of life (HRQoL).

          STUDY DESIGN

          English- or Spanish-speaking women, aged 16–44, with pregnancies <24 weeks gestation were enrolled in this cross-sectional study between June 2014 and June 2015. Participants completed self-assessments of pregnancy “context,” including: timing, intention, wantedness, desirability, happiness, and planning (measured with the London Measure of Unplanned Pregnancy). HRQoL was measured using the Patient Reported Outcomes Measurement Information System Global Short Form (PROMIS-GSF). Associations between measures of pregnancy context and HRQoL scores in the lowest tertile were examined using multivariable logistic regression to adjust for potential confounding variables.

          RESULTS

          We enrolled 161 participants (mean age=27.2±6.6 years). Only 14% self-identified as White, non-Hispanic; 42% Hispanic, 37% Black, non-Hispanic, and 7% multiracial. Most (79%) participants were unmarried, and 75% were parenting. Mean gestational age was 9±4.6 weeks. In unadjusted models, women reporting mixed feelings about wanting to have a baby, an undesired pregnancy, or feeling unhappy about learning of their pregnancy more frequently had low mental and physical HRQoL compared to women reporting wanted, desired, happy pregnancies. Women with an unplanned pregnancy or pregnancy occurring at the wrong time also had lower physical HRQoL than women reporting pregnancies that were planned or happened at the right time. However, after multivariate adjustment, including history of depression, pregnancy contexts were not associated with low mental or physical HRQoL.

          CONCLUSIONS

          After adjusting for multiple confounders, pregnancy context is not significantly associated with HRQoL.

          IMPLICATIONS

          The focus on pregnancy intention in public health programs may not sufficiently assess multidimensional aspects of pregnancy context and may not align with patient-centered outcomes such as HRQoL.

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          Author and article information

          Journal
          0234361
          3163
          Contraception
          Contraception
          Contraception
          0010-7824
          1879-0518
          12 February 2017
          08 February 2017
          May 2017
          01 May 2018
          : 95
          : 5
          : 491-499
          Affiliations
          [1 ]Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT
          [2 ]Department of Psychiatry, Yale School of Medicine, New Haven, CT
          [3 ]Department of Internal Medicine, University of California, Davis, CA
          Author notes
          Corresponding author: Aileen M. Gariepy, MD, MPH, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, 310 Cedar Street, New Haven, CT 06510, Work Phone: 203-737-4665, Private phone: 203-737-6476, Fax: 203-737-6195, aileen.gariepy@ 123456yale.edu
          Article
          PMC5466832 PMC5466832 5466832 nihpa850644
          10.1016/j.contraception.2017.02.001
          5466832
          28188745
          Categories
          Article

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