Development and Use of a Self-Administered Questionnaire for Assessment of Psychologic Attitudes Toward Pregnancy and Their Relation to a Subsequent Premature Birth

Abstract

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.

Measuring the ups and downs of pregnancy stress

“…The content structure of the factors are similar to that generated by other measures of pregnancyspecific stress 13,[34][35][36]62 . These include changes in body image, somatic symptoms, concerns about delivery and the baby's well-being, and changes in social relationships and status among partners, family, and friends intimate relationships with partners.…”

“…Negative emotions, including maternal anxiety and perceived stress, are associated with reduced fetal heart rate variability 1 , greater motor activity 2,3 , alterations in state 4,5 , and disturbances to fetal habituation 6 . Affected outcomes include spontaneous abortions 7,8 , pregnancy complications 9 , shortened length of gestation, preterm delivery and/or low birth weight [10][11][12][13][14][15][16][17] . Several comprehensive reviews detail these associations [18][19][20][21] .…”

Control of bias in dietary trial to prevent coronary recurrences: The Lyon diet heart study

“…According to a methodology previously designed to examine the relationships between psychosocial attitudes and health (Mamelle et al, 1989), this evaluation was conducted in three steps. Brie¯y, in a ®rst descriptive stage, we wanted to highlight how patients of both groups experienced their visits to the Research Unit and their meeting with the investigators (namely the cardiologist, nurse, laboratory technician, secretary, etc), other than the dietician who met only experimental patients.…”

Psychological Prevention of Early Pre-Term Birth: A Reliable Benefit

“…In parallel with this direct intervention for the women, a co-operative work plan was implemented with the nursing staff. The intervention was designed on the basis of psychoanalytic concepts describing pregnancy as an identity crisis, comparable to adolescence, 'through which one passes awakening latent anxiety and conflicts', and on the content analysis of interviews with women who experienced pre-term birth in our previous etiological study [22,[27][28][29]. After the initial interview with its psychoanalytic orientation, an individual support program was proposed for each woman, based on whether the patient requested it and/or the nature of the problem observed by the psychologist.…”

“…The psychological approach allowed the outlining of six psychological dimensions, as follows: pregnancy's effects on the body, feelings of fulfilment during pregnancy, attitudes toward daily life and behaviour while expecting, the role of the baby's father, family ties and maternal identification, and beliefs and superstitions [21]. The epidemiological approach, based on a large prospective study and a self-administered questionnaire built up from these previously outlined dimensions, showed a significant relationship between our 'psychological score' and the risk of pre-term birth [22]. This study contributed to a better understanding of psychological factors that may affect pregnant women and be associated with pre-term birth and allowed us to propose psychotherapeutic support especially devoted to preventing pre-term delivery.…”