TY - JOUR
T1 - Pregnancy intentions' relationship with infant, pregnancy, maternal, and early childhood outcomes
T2 - Evidence from births in Alaska, Missouri, and Oklahoma
AU - Hobby, Erica
AU - Mark, Nicholas D.E.
AU - Gemmill, Alison
AU - Cowan, Sarah K.
N1 - Publisher Copyright:
© 2023 University of Ottawa.
PY - 2023/3
Y1 - 2023/3
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85150875241&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85150875241&partnerID=8YFLogxK
U2 - 10.1363/psrh.12222
DO - 10.1363/psrh.12222
M3 - Article
C2 - 36947635
AN - SCOPUS:85150875241
SN - 1538-6341
VL - 55
SP - 62
EP - 76
JO - Perspectives on Sexual and Reproductive Health
JF - Perspectives on Sexual and Reproductive Health
IS - 1
ER -