222573 Can maternal mindset affect delivery? Lower dispositional optimism is associated with unplanned Cesarean Section deliveries in China

Wednesday, November 10, 2010

Cheryl Moyer, MPH , Global REACH, University of Michigan Medical School, Ann Arbor, MI
Yasmin El-Sayed, BS , Global REACH, University of Michigan, Ann Arbor, MI
YuChun Zhu, MD , Maternal Fetal Medicine, Peking University First Hospital, Beijing, China
Yumei Wei, MD , Maternal Fetal Medicine, Peking University First Hospital, Beijing, China
Cyril M. Engmann, MD FAAP , Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC
Huixia Yang, MD, PhD , Maternal Fetal Medicine, Peking University First Hospital, Beijing, China
Objective: Research suggests that maternal personality factors may influence birth outcomes. This study examined whether maternal optimism was associated with likelihood of unplanned cesarean section births, while adjusting for standard obstetric risk factors. Methods: Data regarding demographics, general health status, optimism/pessimism (using the Life Orientation Test – Revised, (LOT-R)), and mental health (using the Short-Form-12 mental health summary score (SF-12 MCS)) were collected during third trimester prenatal care visits at a tertiary care hospital via self-administered surveys. Late pregnancy and delivery data were collected via chart review. A logistic regression model was constructed with unplanned cesarean section (yes/no) as the outcome variable of interest. Covariates included birthweight, gestational age at delivery, maternal age, pre-existing health issues, pregnancy complications, optimism/pessimism (as measured by the LOT-R), and mental health (as measured by the SF-12). Results: 251 women were enrolled. Complete data on 191 subjects were available and included in the regression model. 19.8 percent (n=38) had unplanned cesarean section deliveries. After adjusting for birthweight, gestational age, maternal age, pre-existing health issues, pregnancy complications, and mental health, lower optimism scores in pregnant mothers were found to be significantly associated with higher unplanned c-section rates. (16.7 LOT-R score, unplanned c-section vs. 18.5 LOT-R score, without an unplanned c-section, p=.007) The regression model explains 13.5% of the variance in unplanned c-section rates (R2 = .135). Conclusion: This study, while preliminary, suggests that optimism during pregnancy may influence the likelihood of c-section delivery. More research is needed to clarify the nature and strength of the relationship.

Learning Areas:
Diversity and culture
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the relationship between optimism and unplanned cesarean section rates as observed in one hospital in Beijing, China. Discuss the implications of non-clinical factors impacting mechanism of delivery or other birth outcomes.

Keywords: Pregnancy Outcomes, Women's Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the Managing Director of the University of Michigan Medical School's international program, Global REACH, and a faculty member in the Department of Medical Education at the University of Michigan. I directed all aspects of the research being presented.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.