title: Are pregnancy planning and timing associated with preterm or small for gestational age births?
abstract: OBJECTIVE
  To investigate whether unplanned or poorly timed pregnancies (self-reported at enrollment) are associated with preterm or small for gestational age births.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Two thousand six hundred fifty-four pregnant women <18 weeks estimated gestational age with a singleton pregnancy.
  
  
  METHODS
  None.
  
  
  METHODS
  Preterm and small for gestational age births.
  
  
  RESULTS
  In adjusted analyses, pregnancy planning was not statistically significantly associated with preterm (odds ratio [OR] 1.18; 95% confidence interval [CI], 0.85-1.65) or small for gestational age birth (OR 1.17; 95% CI, 0.69-1.97). Similarly, poorly timed pregnancies were not statistically significantly associated with preterm (OR 0.85; 95% CI, 0.53-1.38) or small for gestational age birth (OR 0.92; 95% CI, 0.65-1.29). Combining pregnancy planning (yes/no) and timing (yes/no) into a 4-level category showed no statistically significant association with preterm birth or small for gestational age.
  
  
  CONCLUSIONS
  In a large cohort with antenatally assessed pregnancy planning and timing, outcome data collected from medical record abstraction, and robust analysis adjusting for multiple confounding factors including maternal demographics, medical conditions, and other risk factors, neither pregnancy planning nor pregnancy timing showed a statistically significant association with preterm or small for gestational age infants. This study improves upon previous analyses that lacked adjustment for confounding and used retrospective self-reporting to assess pregnancy planning and timing, and preterm and small for gestational age births. Findings may differ in higher risk populations with higher prevalence of preterm or small for gestational age births.
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, Yale University, New Haven, Connecticut. Electronic address: aileen.gariepy@yale.edu.
authors.forename: Aileen M
authors.initials: AM
authors.lastname: Gariepy
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, Yale University, New Haven, Connecticut.
authors.forename: Lisbet S
authors.initials: LS
authors.lastname: Lundsberg
authors.affiliation: Yale Center for Analytical Sciences, School of Public Health, Yale University, New Haven, Connecticut.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Stolar
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, Yale University, New Haven, Connecticut.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Stanwood
authors.affiliation: Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, Yale University, New Haven, Connecticut; Department of Psychiatry, School of Medicine, Yale University, New Haven, Connecticut.
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Yonkers
mesh_terms: D000328:Adult; D015897:Comorbidity; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D007407:Interviews as Topic; D016015:Logistic Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D047928:Premature Birth / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Preterm birth; small for gestational age; unplanned pregnancy