This paper describes both the development of and results of the use of a self-administered questionnaire designed specifically to investigate the relation between the psychologic attitudes of pregnant women toward pregnancy and an eventual subsequent premature birth. The questionnaire (entitled Pregnancy Psychologic Attitudes Test--in relation to Premature Birth [PPAT(p)]) was derived from the synthesis of interviews with women who had given birth prematurely, comprised 40 questions grouped in six dimensions, and was used in a prospective survey. All women who had an antenatal visit in their fifth to sixth month of pregnancy in one of four maternity hospitals in Lyon, France, between October 1983 and March 1985 were asked to complete this questionnaire. A quantitative PPAT(p) score (ranging from 0 to 6) was constructed in a working sample (n = 643), and its relation with a subsequent premature birth was analyzed in a study sample (n = 1,500). Application of the logistic regression model showed, after controlling for personal and medical factors, that this relation was statistically significant. The risk of premature birth increased from 1 to 1.5 when the PPAT(p) score increased one point (p less than 0.001). This study contributes to a better understanding of psychologic factors that may affect pregnant women and be associated with premature birth. This new component must be considered in the development of policies for preventing premature birth.

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In the Lyon region of France, 356 couples of childbearing age were interviewed regarding their fertility intentions. Couples intending to have, and not to have, further children were compared. The former are less often skilled workers or qualified office staff, the woman is less likely to work, and the couple had their first child at a relatively late age. These differences are still present after adjustment for the couple's ages and number of children.

The aim of this investigation was to explore whether, within the scope of personality traits and their modifications during pregnancy, the obsessional dimension may have a protective role against premature birth. In fact, obsessional characterology with its tendency to control may suggest that the women with these traits do not passively experience their pregnancy and may try to control its evolution, at least in their fantasies. Personality dimensions have been recorded using Derogatis' psychological self-administered questionnaire, in which women were asked to assess their level on the Derogatis symptom scale before and during pregnancy. The survey involved 351 women (117 premature and 234 term deliveries) who had both completed the self-administered questionnaire on the 6-month pregnancy visit and answered a specific interview at birth. Our results have shown that the existence of obsessional traits before pregnancy apparently does not have a protective role against premature delivery (odds ratio = 1.40; NS). Conversely, intensified obsessional symptoms during pregnancy are associated with a decreased premature birth rate (odds ratio = 0.44; p < 0.05). These results remain when the presence of obsessional traits before pregnancy is taken into account (adjusted odds ratio = 0.38; p < 0.02). The possibility of a defence reaction to this situation of pregnancy is discussed.