240257 Environmental exposures, pregnancy intention, and behavioral choice

Wednesday, November 2, 2011: 11:30 AM

Pamela Maxson, PhD , Children's Environmental Health Initiative, Duke University, Durham, NC
Sharon Edwards, MS , Children's Environmental Health Initiative, Duke University, Durham, NC
Marie Lynn Miranda, PhD , Children's Environmental Health Initiative, Duke University, Durham, NC
Background: Adverse birth outcomes are associated with unwanted pregnancies (UWP) and exposure to environmental contaminants. Maternal behavioral choices affect exposures and may be affected by pregnancy intention. Objective: Examine associations between environmental exposures and behavioral choices among women in different pregnancy intention categories. Methods: We examine how pregnancy intention impacts prenatal behavior and among 1518 women (1188 non-Hispanic black; 330 non Hispanic white; oversampling of NHB intended) enrolled in a prospective cohort study. Psychosocial and behavioral correlates were obtained through prenatal surveys; pregnancy outcomes were collected from medical records. Environmental contaminants were measured in maternal blood samples collected at delivery. Multivariable, multinomial analyses were run controlling for demographics. Results: Behavioral choices varied with pregnancy intention. UWP were more likely to report smoking (28%, 19%, 13%, UWP, Mistimed, Wanted, respectively, p<.001) and were at higher odds of being exposed to ETS (OR = 1.72, 95% CI (1.1, 2.8)) than women with wanted pregnancies. UWP were more likely to report a history of drug use (OR = 1.9, 95% CI (1.1, 3.4)) that continued during pregnancy (p<.01). Women with wanted pregnancies were more likely to have detectable mercury (ng/mL), indicating they consumed more fish prenatally (p<.01). Conclusions: Pregnancy intention was strongly correlated with behavioral choices linked to environmental exposures related to birth outcomes. We speculate that the exposures interact with the social environment and maternal health. The combination of an increased likelihood of exposure to environmental contaminants, an at-risk profile, and an unintended pregnancy may jeopardize maternal and infant health.

Learning Areas:
Environmental health sciences
Social and behavioral sciences

Learning Objectives:
Identify relationships between pregnancy intention, environmental exposures, and behavioral choice. Name behavioral choices which differ across pregnancy intention categories.

Keywords: Pregnancy, Environmental Exposures

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the project manager of the study and have performed the analyses and background for the project.
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.