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Wang Y, Wei R, Chen Z, Tang Y, Liu L, Qiao P, Ren C, Yu Z, Lu C. The association between the number of pregnancies and depressive symptoms: A population-based study. J Affect Disord 2024; 350:411-419. [PMID: 38244784 DOI: 10.1016/j.jad.2024.01.161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 12/05/2023] [Accepted: 01/14/2024] [Indexed: 01/22/2024]
Abstract
BACKGROUND Depression is a psychosomatic disorder that affects reproductive health. The number of pregnancies is an important indicator of reproductive health. Multiple pregnancies and births may aggravate the risk of depression in females. However, the evidence of the connection between the number of pregnancies and depression is unclear. We aimed to investigate the relationship between the number of pregnancies and depressive symptoms. METHODS We used the National Health and Nutrition Examination Survey (NHANES) data with a total of 17,216 women from 2005 to 2020. The number of pregnancies obtained from the self-report questionnaire. Depressive symptoms were measured by the nine-item patient health questionnaire (PHQ-9). Multivariate logistic regression models were used to examine the risk factors of depression. The restricted cubic spline (RCS) was applied to explore the nonlinear relationship. In addition, subgroup analysis was used to support the accuracy of our findings. RESULTS We found that the number of pregnancies is positively associated with the prevalence of depression. According to the multivariable logistic regression analysis, pregnant women was 1.52-fold higher than the normal group to experience depression in the fully-adjusted model. No interaction between number of pregnancies and covariates in subgroups. LIMITATIONS This study was cross-sectional, which limits its ability to draw conclusions about the causal relationship between the number of pregnancies and depression. CONCLUSION In the United States, the number of pregnancies was positively associated with the prevalence of depression. It is critical to register the number of pregnancies for monitoring depressive symptoms.
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Affiliation(s)
- Yadi Wang
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, PR China; School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China
| | - Ran Wei
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, PR China; School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China
| | - Zhenna Chen
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China; Department of Ophthalmology, Afffliated Hospital of Weifang Medical University, Weifang, Shandong, PR China
| | - Yujie Tang
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, PR China; School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China
| | - Lu Liu
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, PR China; School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China
| | - Pengyun Qiao
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, PR China; School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China
| | - Chune Ren
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, PR China; School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China.
| | - Zhenhai Yu
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, PR China; School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China.
| | - Chao Lu
- Department of Reproductive Medicine, Affiliated Hospital of Weifang Medical University, Weifang, Shandong Province, PR China; School of Clinical Medicine, Weifang Medical University, Weifang, Shandong Province, PR China.
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Do Older Women of Reproductive Age Have Better Diet Quality than Younger Women of Reproductive Age? Nutrients 2021; 13:nu13113830. [PMID: 34836086 PMCID: PMC8625416 DOI: 10.3390/nu13113830] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/23/2021] [Accepted: 10/23/2021] [Indexed: 11/20/2022] Open
Abstract
There is increasing recognition of the importance of nutrition for reproductive health, but little is known regarding the diet quality of younger vs. older reproductive aged women, and how their intakes relate to dietary recommendations. The purpose of the study was to examine the diets of younger (19–35 years old) compared to older (35–50 years old) reproductive aged women, and how they align with dietary recommendations. Women aged 19–50 years from the 2011–13 Australian National Nutrition and Physical Activity Survey were included (n = 2323). Dietary intakes were assessed by a single 24-h dietary recall and were compared to (i) Australian Dietary Guidelines; (ii) Acceptable Macronutrient Distribution for protein, carbohydrates, and fat; and (iii) Dietary Guideline Index (DGI). Regression analyses comparing younger and older women against recommendations were undertaken, with confounders determined a priori. There was no difference between older and younger women in meeting food group recommendations, with 26% of all women meeting recommendations for fruit, and meat and alternatives, and <20% meeting recommendations for vegetables and alternatives, grains, and dairy. Although there was no difference between older and younger women in total DGI score (mean (SE) 75.6 (1.7) vs. 74.5 (2.5), p > 0.05), older women had higher component scores in limiting saturated fat, consuming low-fat milk, and limiting adding salt during cooking. Continued health promotion for women of reproductive age should be a key priority to improve their own health and that of future generations.
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Geist C, Everett BG, Simmons RG, Sanders JN, Gawron LM, Myers K, Turok DK. Changing lives, dynamic plans: Prospective assessment of 12-month changes in pregnancy timing intentions and personal circumstances using data from HER Salt Lake. PLoS One 2021; 16:e0257411. [PMID: 34543298 PMCID: PMC8451991 DOI: 10.1371/journal.pone.0257411] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/31/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives To explore the association between changes in personal circumstances and shifts in pregnancy intentions. Study design New start contraceptive clients, who desired to prevent pregnancy for at least one year enrolled in the survey arm of the HER Salt Lake Contraceptive Initiative (September 2015 –March 2017) and responded to the question “What are your future pregnancy plans?” at enrollment and 12-month follow-up. We estimated multivariable binary logistic fixed-effects regressions to examine the association between changes in personal circumstances and a change from never desiring a pregnancy at enrollment to considering one in the future at 12-month follow-up. Results The majority of the 2825 participants (2246, 79%) maintained their pregnancy timing intention over the 12-month study period. Multivariable analyses of the 208 participants who changed from never desiring a pregnancy to considering pregnancy in the future at 12-month follow-up indicated that entering cohabitation (aOR 3.14, 95% CI 1.30–7.58), increased household income (aOR 1.06, 95% CI 1.00–1.13), and changes from unemployment to full-time employment (aOR 5.94, 95% CI 1.29–27.36) are associated with increased the odds of desiring a future pregnancy after never wanting one a year prior. Conclusions Pregnancy intentions are dynamic over twelve months and covary with partner status, household income, and employment status. Pregnancy intentions are linked to changes in life circumstances. Health care providers need to frequently assess pregnancy intentions and resulting contraceptive or preconception needs.
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Affiliation(s)
- C. Geist
- Department of Sociology and Division of Gender Studies, University of Utah, Salt Lake City, Utah
- Department of Obstetrics & Gynecology, University of Utah, Salt Lake City, Utah
- * E-mail:
| | - B. G. Everett
- Department of Sociology and Division of Gender Studies, University of Utah, Salt Lake City, Utah
- Department of Obstetrics & Gynecology, University of Utah, Salt Lake City, Utah
| | - R. G. Simmons
- Department of Obstetrics & Gynecology, University of Utah, Salt Lake City, Utah
| | - J. N. Sanders
- Department of Obstetrics & Gynecology, University of Utah, Salt Lake City, Utah
| | - L. M. Gawron
- Department of Obstetrics & Gynecology, University of Utah, Salt Lake City, Utah
| | - K. Myers
- Department of Obstetrics & Gynecology, University of Utah, Salt Lake City, Utah
| | - D. K. Turok
- Department of Obstetrics & Gynecology, University of Utah, Salt Lake City, Utah
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Gilbertson PK, Forrester S, Andrews L, McCann K, Rogers L, Park C, Moye J. The National Children's Study Archive Model: A 3-Tier Framework for Dissemination of Data and Specimens for General Use and Secondary Analysis. Front Public Health 2021; 9:526286. [PMID: 33748052 PMCID: PMC7973013 DOI: 10.3389/fpubh.2021.526286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 01/26/2021] [Indexed: 01/12/2023] Open
Abstract
The National Children's Study (NCS) Archive was created as a repository of samples, data, and information from the NCS Vanguard Study-a longitudinal pregnancy and birth cohort evaluating approaches to study influence of environmental exposures on child health and development-to provide qualified researchers with access to NCS materials for use in secondary research. The National Children's Study Archive (NCSA) model is a 3-tiered access model designed to make the wealth of information and materials gathered during the NCS Vanguard Study available at a user appropriate level. The NCSA model was developed as a 3-tier framework, for users of varying access levels, providing intuitive data exploration and visualization tools, an end-to-end data and sample request management system, and a restricted portal for participant-level data access with a team of experts available to assist users. This platform provides a model to accelerate transformation of information and materials from existing studies into new scientific discoveries. Trial Registration: ClinicalTrials.gov Identifier: NCT00852904 (first posted February 27, 2009).
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Affiliation(s)
| | - Susan Forrester
- Social & Scientific Systems Inc., Silver Spring, MD, United States
| | - Linda Andrews
- Social & Scientific Systems Inc., Silver Spring, MD, United States
| | - Kathleen McCann
- Social & Scientific Systems Inc., Silver Spring, MD, United States
| | - Lydia Rogers
- Social & Scientific Systems Inc., Silver Spring, MD, United States
| | - Christina Park
- National Institutes of Health, Office of the Director, Bethesda, MD, United States
| | - Jack Moye
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States
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Schrager NL, Wesselink AK, Wang TR, Hatch EE, Rothman KJ, Mikkelsen EM, Boynton-Jarrett RD, Wise LA. Association of income and education with fecundability in a North American preconception cohort. Ann Epidemiol 2020; 50:41-47.e1. [PMID: 32681982 PMCID: PMC7541799 DOI: 10.1016/j.annepidem.2020.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 06/30/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE The purpose of this study is to evaluate socioeconomic determinants of fecundability. METHODS Among 8654 female pregnancy planners from Pregnancy Study Online, a North American prospective cohort study (2013-2019), we examined associations between socioeconomic status and fecundability (the per-cycle probability of conception). Information on income and education was collected via baseline questionnaires. Bimonthly follow-up questionnaires were used to ascertain pregnancy status. We estimated fecundability ratios (FRs) and 95% confidence intervals (CIs) using proportional probabilities regression, controlling for potential confounders. RESULTS Relative to an annual household income of greater than or equal to $150,000, adjusted FRs were 0.91 (95% CI: 0.83-1.01) for less than $50,000, 0.99 (95% CI: 0.92-1.07) for $50,000-$99,000, and 1.09 (95% CI: 1.01-1.18) for $100,000-$149,000. FRs for less than 12, 13-15, and 16 years of education, relative to greater than or equal to 17 years, were 0.90 (95% CI: 0.76-1.08), 0.84 (95% CI: 0.78-0.91), and 0.89 (95% CI: 0.84-0.95), respectively. Slightly stronger associations for income and education were seen among older women. CONCLUSIONS Lower levels of education and income were associated with modestly reduced fecundability. These results demonstrate the presence of socioeconomic disparities in fecundability.
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Affiliation(s)
- Nina L Schrager
- Department of Epidemiology, Boston University School of Public Health, Boston, MA.
| | - Amelia K Wesselink
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Tanran R Wang
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Elizabeth E Hatch
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Kenneth J Rothman
- Department of Epidemiology, Boston University School of Public Health, Boston, MA; RTI Health Solutions, Research Triangle Park, NC
| | - Ellen M Mikkelsen
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | | | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
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Gómez AM, Arteaga S, Villaseñor E, Arcara J, Freihart B. The Misclassification of Ambivalence in Pregnancy Intentions: A Mixed-Methods Analysis. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2019; 51:7-15. [PMID: 30762937 PMCID: PMC6476569 DOI: 10.1363/psrh.12088] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 11/16/2018] [Accepted: 11/20/2018] [Indexed: 05/23/2023]
Abstract
CONTEXT Researchers have developed various measures of pregnancy ambivalence in an effort to capture the nuance overlooked by conventional, binary measures of pregnancy intention. However, the conceptualization and operationalization of the concept of ambivalence vary widely and may miss the complexity inherent in pregnancy intentions, particularly for young people, among whom unintended pregnancy rates are highest. METHODS To investigate the utility and accuracy of current measures of pregnancy ambivalence, a mixed-methods study was conducted with 50 young women and their male partners in northern California in 2015-2016. Survey data were used to descriptively analyze six existing pregnancy ambivalence measures; in-depth interviews addressing pregnancy desires and plans were deductively coded and thematically analyzed to understand why some participants appeared to be ambivalent from the survey data when their interview responses suggested otherwise. RESULTS Eighty participants would be considered ambivalent by at least one measure. After assessment of the interview data, however, these measures were deemed to have misclassified almost all (78) participants. Qualitative analysis revealed several themes regarding misclassification: conflation of current pregnancy desires with expected postconception emotional responses; acceptability of an undesired pregnancy; tempering of survey responses to account for partners' desires; perceived lack of control regarding pregnancy; and, among participants with medical conditions perceived to impact fertility, subjugation of pregnancy desires in the interest of self-protection. CONCLUSIONS Current approaches to measuring pregnancy ambivalence may fail to capture the intricacies of pregnancy intentions and may be ineffective if they do not account for young people's experiences, especially when used to inform clinical practice, programs and policy.
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Affiliation(s)
- Anu Manchikanti Gómez
- Assistant Professor and Director, Sexual Health and Reproductive Equity (SHARE) Program, School of Social Welfare, University of California, Berkeley
| | - Stephanie Arteaga
- Research Associate, Sexual Health and Reproductive Equity (SHARE) Program, School of Social Welfare, University of California, Berkeley
| | - Elodia Villaseñor
- Project Director, Sexual Health and Reproductive Equity (SHARE) Program, School of Social Welfare, University of California, Berkeley
| | - Jennet Arcara
- Research Associate, Sexual Health and Reproductive Equity (SHARE) Program, School of Social Welfare, University of California, Berkeley
| | - Bridget Freihart
- Graduate Student Researcher, Sexual Health and Reproductive Equity (SHARE) Program, School of Social Welfare, University of California, Berkeley
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