title: Pregnancy intendedness, maternal psychosocial factors and preterm birth.
abstract: OBJECTIVE
  This study examined associations between reported pregnancy intendedness and several maternal psychosocial factors in relation to preterm birth (<37 weeks' completed gestation).
  
  
  METHODS
  Women were recruited into a prospective cohort study between the 24th and 29th weeks of pregnancy in central North Carolina from 1996 to 2000. Prior to delivery, participants responded to questions about pregnancy intendedness, life events impacts, depressive symptoms, and coping style.
  
  
  RESULTS
  Women who reported not intending their pregnancy had increased odds of reporting low, medium and high levels of perceived stress during pregnancy (OR = 1.4 [95% CI: 1.1, 1.9], OR = 2.2 [95% CI: 1.7, 2.8], and OR = 3.4 [95% CI: 2.6, 4.5], respectively, relative to very low), medium and high levels of depressive symptoms (OR = 2.2 [95% CI: 1.8, 2.9] and OR = 3.1 [95% CI: 2.4, 3.9], respectively), and medium and high levels of several coping styles. Reporting not intending the pregnancy was not associated with increased risk of preterm birth (Risk Ratio [RR] = 1.0, 95% CI: 0.8, 1.1), but reporting the highest quartile of perceived stress (RR = 1.6, 95% CI: 1.1, 2.3) and the highest tertile of distancing coping style (compared with lowest quartile) was associated with preterm birth (RR = 1.4, 95% CI: 1.1, 1.9). Interactions between pregnancy intendedness and the psychosocial variables perceived stress, depression or coping style did not modify the psychosocial variable's associations with preterm birth.
  
  
  CONCLUSIONS
  Pregnancy intendedness remains an important concept in the reproductive health literature integrally tied to indicators of maternal mental health, but not necessarily to pregnancy outcomes.
authors.affiliation: USEPA/NHEERL Human Studies Division MD 58A, Research Triangle Park, NC 27711, USA. lmesser@email.unc.edu
authors.forename: Lynne C
authors.initials: LC
authors.lastname: Messer
authors.forename: Nancy
authors.initials: N
authors.lastname: Dole
authors.forename: Jay S
authors.initials: JS
authors.lastname: Kaufman
authors.forename: David A
authors.initials: DA
authors.lastname: Savitz
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D033182:Intention; D009035:Mothers / Q000523:psychology*; D009657:North Carolina; D011247:Pregnancy; D047928:Premature Birth / Q000523:psychology*; D011446:Prospective Studies; D011584:Psychology