Impact of psychosocial health on pregnancy intention

Nationally, 49% of pregnancies are either mistimed (occur earlier than desired) or unwanted. Pregnancy intention at time of conception influences prenatal preparation and behavior. Women who experience an unintended pregnancy are more likely to have other risk factors that increase the chance of poor maternal and child health outcomes. In Duke's Healthy Pregnancy, Healthy Baby Study, 511 pregnant women have been recruited to date from Duke University Medical Center and Lincoln Community Health Center in Durham, NC. The sample consists of 349 non-Hispanic black women, 100 non-Hispanic white women, 50 Hispanic women, and 18 Asian women. Maternal medical history and birth outcomes have been obtained on 375 women.

We assess the influence of psychosocial health on pregnancy intention, using validated instruments to measure pregnancy intention, perceived racism, depression, and John Henryism. Pregnancy intention was strongly predicted by depression (CES-D) and perceived racism, but not by John Henryism. For example, women who scored higher on depression were more likely to have indicated this was an unintended pregnancy.

Pregnancy intention was not related to either gestational age or birth weight, although higher scores on John Henryism were related to greater gestational age at birth. In related work, we are exploring the relationship between pregnancy intention and personality (using the NEO-FFI), self-efficacy, and a variety of demographic variables.