title: Stressful Life Events Around the Time of Unplanned Pregnancy and Women's Health: Exploratory Findings from a National Sample.
abstract: Objective Little is known about how women's social context of unintended pregnancy, particularly adverse social circumstances, relates to their general health and wellbeing. We explored associations between stressful life events around the time of unintended pregnancy and physical and mental health. Methods Data are drawn from a national probability study of 1078 U.S. women aged 18-55. Our internet-based survey measured 14 different stressful life events occurring at the time of unintended pregnancy (operationalized as an additive index score), chronic disease and mental health conditions, and current health and wellbeing symptoms (standardized perceived health, depression, stress, and discrimination scales). Multivariable regression modeled relationships between stressful life events and health conditions/symptoms while controlling for sociodemographic and reproductive covariates. Results Among ever-pregnant women (N = 695), stressful life events were associated with all adverse health outcomes/symptoms in unadjusted analyses. In multivariable models, higher stressful life event scores were positively associated with chronic disease (aOR 1.21, CI 1.03-1.41) and mental health (aOR 1.42, CI 1.23-1.64) conditions, higher depression (B 0.37, CI 0.19-0.55), stress (B 0.32, CI 0.22-0.42), and discrimination (B 0.74, CI 0.45-1.04) scores, and negatively associated with ≥ very good perceived health (aOR 0.84, CI 0.73-0.97). Stressful life event effects were strongest for emotional and partner-related sub-scores. Conclusion Women with adverse social circumstances surrounding their unintended pregnancy experienced poorer health. Findings suggest that reproductive health should be considered in the broader context of women's health and wellbeing and have implications for integrated models of care that address women's family planning needs, mental and physical health, and social environments.
authors.affiliation: Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road, NE, GCR 560, Atlanta, GA, 30322, USA. kelli.s.hall@emory.edu.|Department of Obstetrics and Gynecology, L4000 Women's Hospital, 1500 East Medical Center Dr., University of Michigan, Ann Arbor, MI, 48109, USA. kelli.s.hall@emory.edu.
authors.forename: Kelli Stidham
authors.initials: KS
authors.lastname: Hall
authors.affiliation: Department of Obstetrics and Gynecology, L4000 Women's Hospital, 1500 East Medical Center Dr., University of Michigan, Ann Arbor, MI, 48109, USA.
authors.forename: Vanessa K
authors.initials: VK
authors.lastname: Dalton
authors.affiliation: Department of Obstetrics and Gynecology, L4000 Women's Hospital, 1500 East Medical Center Dr., University of Michigan, Ann Arbor, MI, 48109, USA.
authors.forename: Melissa
authors.initials: M
authors.lastname: Zochowski
authors.affiliation: Department of Obstetrics and Gynecology, L4000 Women's Hospital, 1500 East Medical Center Dr., University of Michigan, Ann Arbor, MI, 48109, USA.
authors.forename: Timothy R B
authors.initials: TRB
authors.lastname: Johnson
authors.affiliation: Department of Obstetrics and Gynecology, L4000 Women's Hospital, 1500 East Medical Center Dr., University of Michigan, Ann Arbor, MI, 48109, USA.
authors.forename: Lisa H
authors.initials: LH
authors.lastname: Harris
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008603:Mental Health; D008875:Middle Aged; D011159:Population Surveillance; D011247:Pregnancy; D049168:Pregnancy, Unplanned / Q000523:psychology*; D037841:Pregnant People / Q000523:psychology*; D013315:Stress, Psychological / Q000523:psychology*
keywords: Chronic disease; Mental health; Reproductive health; Stress; Stressful life events; Unintended pregnancy