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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2013

Open Access 01-12-2013 | Research article

Age, mode of conception, health service use and pregnancy health: a prospective cohort study of Australian women

Authors: Jane Fisher, Karen Wynter, Karin Hammarberg, John McBain, Frances Gibson, Jacky Boivin, Catherine McMahon

Published in: BMC Pregnancy and Childbirth | Issue 1/2013

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Abstract

Background

There is limited evidence about the ways in which maternal age and mode of conception interact with psychological, sociodemographic, health and health service factors in governing pregnancy health. The aim of this study was to establish in what ways maternal age and mode of conception are associated with, health behaviours, health service use and self-rated physical and mental health during pregnancy.

Method

A prospective cohort study was conducted in a collaboration between universities, infertility treatment services and public and private obstetric hospitals in Melbourne and Sydney, Australia,. Consecutive cohorts of nulliparous English-literate women at least 28 weeks pregnant who had conceived through ART (ARTC) or spontaneously (SC) in three age-groups: 20–30; 31–36 and at least 37 years were recruited. Data were obtained via structured individual telephone interviews and self-report postal questionnaires at recruitment and four months postpartum. Study-specific questions assessed: sociodemographic characteristics; reproductive health; health behaviours and health service use. Standardized instruments assessed physical health: SF 12 Physical Component Score (PCS) and mental health: SF12 Mental Component Score (MCS); State Trait Anxiety Inventory and Edinburgh Postnatal Depression Scale. The main outcome measures were the SF 12 PCS, SF12 MCS scores and pregnancy-related hospital admissions.

Results

Of 1179 eligible women 791 (67%) participated, 27 had fertility treatment without oocyte retrieval and were excluded and 592/764 (78%) completed all pregnancy assessments. When other factors were controlled speaking a language other than English, having private health insurance and multiple gestation were associated with worse physical health and having private health insurance and better physical health were associated with better mental health. Pregnancy-related hospital admissions were associated with worse physical health and multiple gestation.

Conclusions

Maternal age and mode of conception are not associated with pregnancy health and health service use when sociodemographic factors are considered.
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Literature
1.
Australian Bureau of Statistics: Births Australia. 2010, Canberra, Australia:
2.
Office for National Statistics: Statistical Bulletin. 2010, Fareham, UK: Live births in England and Wales by characteristics of mother
3.
Matthews TJ, Hamilton BE: Delayed childbearing: more women are having their first child later in life. NCHS Data Brief. 2009, 21: 1-8.PubMed
4.
5.
Laws P, Li Z, Sullivan E: Australia’s mothers and babies 2008. 2010, Canberra: AIHW
6.
Hurst T, Lancaster P: Assisted conception Australia and New Zealand 1998 and 1999. 2001, Canberra: AIHW
7.
Ataullah I, Freeman-Wang T: The older obstetric patient. Curr Obstet Gynaecol. 2005, 15: 46-53. 10.1016/j.curobgyn.2004.09.006.CrossRef
8.
Joseph KS, Allen AC, Dodds L, Turner LA, Scott H, Liston R: The perinatal effects of delayed childbearing. Obstet Gynecol. 2005, 105: 1410-8. 10.1097/01.AOG.0000163256.83313.36.CrossRefPubMed
9.
Jolly M, Sebire N, Harris J, Robinson S, Regan L: The risks associated with pregnancy in women aged 35 years or older. Hum Reprod. 2000, 15: 2433-7. 10.1093/humrep/15.11.2433.CrossRefPubMed
10.
Aref-Adib M, Freeman-Wang T, Ataullah I: The older obstetric patient. Obstet Gynecol Reprod Med. 2008, 18: 43-8. 10.1016/j.ogrm.2007.12.001.CrossRef
11.
Ozalp S, Tanir HM, Sener T, Yazan S, Keskin AE: Health risks for early and late childbearing. Arch Gynecol Obstet. 2003, 268: 172-4. 10.1007/s00404-002-0359-7.CrossRefPubMed
12.
Bell JS, Campbell DM, Graham WJ, Penney GC, Ryan M, Hall MH: Can obstetric complications explain the high levels of obstetric interventions and maternity service use among older women? A retrospective analysis of routinely collected data. Br J Obstet Gynaecol. 2001, 108: 910-8.
13.
Braveman FR: Pregnancy in patients of advanced maternal age. Anesthesiol Clin. 2006, 24: 637-46. 10.1016/j.atc.2006.05.002.CrossRefPubMed
14.
Bewley S, Davies M, Braude P: Which career first? The most secure age for childbearing remains 20–35. Br Med J. 2005, 331: 588-9. 10.1136/bmj.331.7517.588.CrossRef
15.
Kausar S, Bewley S: Pregnancy after the age of 40. Womens Health (Lond Engl). 2006, 2: 839-45. 10.2217/17455057.2.6.839.CrossRef
16.
Chandra A, Stephen EH: Infertility service use among U.S. women: 1995 and 2002. Fertil Steril. 2010, 93: 725-36. 10.1016/j.fertnstert.2008.10.049.CrossRefPubMed
17.
Society of Obstetricians and Gynaecologists of Canada and the Board of the Canadian Fertility and Andrology Society: Pregnancy Outcomes After Assisted Reproductive Technology. J Obstet Gynaecol Can. 2006, 28: 220-233.CrossRef
18.
Koleva H, Stuart S, O’Hara MW, Bowman-Reif J: Risk factors for depressive symptoms during pregnancy. Arch Womens Ment Health. 2011, 14: 99-105. 10.1007/s00737-010-0184-0.CrossRefPubMed
19.
Rich-Edwards JW, Kleinman K, Abrams A, Harlow BL, McLaughlin TJ, Joffe H: Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. J Epidemiol Community Health. 2006, 60: 221-7. 10.1136/jech.2005.039370.CrossRefPubMedPubMedCentral
20.
Lampinen R, Vehvilainen-Julkunen K, Kankkunen P: A review of pregnancy in women over 35 years of age. Open Nurs J. 2009, 3: 33-8. 10.2174/1874434600903010033.CrossRefPubMedPubMedCentral
21.
Robb FV, Alder EM, Prescott RJ: Do older primigravidas differ from younger primigravidas in their emotional experience of pregnancy?. J Reprod Infant Psyc. 2005, 23: 135-41. 10.1080/02646830500129313.CrossRef
22.
Hammarberg K, Fisher JRW, Wynter KH: Psychological and social aspects of pregnancy, childbirth and early parenting after assisted conception: a systematic review. Hum Reprod Update. 2008, 14: 395-414. 10.1093/humupd/dmn030.CrossRefPubMed
23.
McMahon CA, Gibson FL, Allen JL, Saunders D: Psychosocial adjustment during pregnancy for older couples conceiving through assisted reproductive technology. Hum Reprod. 2007, 22: 1168-74. 10.1093/humrep/del502.CrossRefPubMed
24.
Klemetti R, Kurinczuk JJ, Redshaw M: Older women’s pregnancy related symptoms, health and use of antenatal services. Eur J Obstet Gynecol Reprod Biol. 2011, 154: 157-62. 10.1016/j.ejogrb.2010.10.025.CrossRefPubMed
25.
Ware JE, Kosinski M, Keller SD: A 12-Item Short-Form Health Survey: Construction of Scales and Preliminary Tests of Reliability and Validity. Med Care. 1996, 34: 220-33. 10.1097/00005650-199603000-00003.CrossRefPubMed
26.
Ware JE, Snow K, Kosinski M, Gandek B: SF-36 Health Survey: Manual and interpretation guide. 1993, Boston: New England Medical Center, Health Institute
27.
Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE: Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: Results from the IQOLA Project. J Clin Epidemiol. 1998, 51: 1171-8. 10.1016/S0895-4356(98)00109-7.CrossRefPubMed
28.
Fisher JR, Hammarberg K, Baker GH: Antenatal mood and fetal attachment after assisted conception. Fertil Steril. 2008, 89: 1103-12. 10.1016/j.fertnstert.2007.05.022.CrossRefPubMed
29.
McMahon CA, Boivin J, Gibson FL, Hammarberg K, Wynter KH, Saunders D: Age at first birth, mode of conception and psychological wellbeing in pregnancy: findings from the parental age and transition to parenthood Australia (PATPA) study. Hum Reprod. 2011, 26: 1389-98. 10.1093/humrep/der076.CrossRefPubMed
30.
Spielberger CD: Manual for the State-Trait Anxiety Inventory (Form Y). 1983, Palo Alto, California: Consulting Psychologists Press
31.
Grant K-A, McMahon CA, Austin M-P: Maternal anxiety during the transition to parenthood: a prospective study. J Affect Disord. 2008, 108: 101-11. 10.1016/j.jad.2007.10.002.CrossRefPubMed
32.
Cox J, Holden J, Sagovsky R: Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987, 150: 782-6. 10.1192/bjp.150.6.782.CrossRefPubMed
33.
Murray D, Cox JL: Screening for depression during pregnancy with the edinburgh depression scale (EDDS). J Reprod Infant Psyc. 1990, 8: 99-107. 10.1080/02646839008403615.CrossRef
34.
Matthey S, Henshaw C, Elliott S, Barnett B: Variability in use of cut-off scores and formats on the Edinburgh Postnatal Depression Scale - implications for clinical and research practice. Arch Womens Ment Health. 2006, 9: 309-15. 10.1007/s00737-006-0152-x.CrossRefPubMed
35.
Hammarberg K, Rowe H, Fisher JR: Early post-partum adjustment and admission to parenting services in Victoria, Australia after assisted conception. Hum Reprod. 2009, 24: 2801-9. 10.1093/humrep/dep282.CrossRefPubMed
36.
Mishra G, Schofield MJ: Norms for the physical and mental health component summary scores of the SF-36 for young, middle-aged and older Australian women. Qual Life Res. 1998, 7: 215-20. 10.1023/A:1008821913429.CrossRefPubMed
37.
Evans J, Jon H, Francomb H, Oke S, Golding J: Cohort Study Of Depressed Mood During Pregnancy And After Childbirth. Br Med J. 2001, 323: 257-60. 10.1136/bmj.323.7307.257.CrossRef
38.
Kermode M, Fisher J, Jolley D: Health insurance status and mood during pregnancy and following birth: a longitudinal study of mulitparous women. Aust N Z J Psychiatry. 2000, 34: 664-70. 10.1080/j.1440-1614.2000.00741.x.CrossRefPubMed
Metadata
Title
Age, mode of conception, health service use and pregnancy health: a prospective cohort study of Australian women
Authors
Jane Fisher
Karen Wynter
Karin Hammarberg
John McBain
Frances Gibson
Jacky Boivin
Catherine McMahon
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2013
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-13-88

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