Guedes Maryse, Canavarro Maria Cristina
J Midwifery Womens Health. 2014 Sep-Oct;59(5):483-93. doi: 10.1111/jmwh.12205. Epub 2014 Sep 5.
First childbirth at advanced maternal age has become a growing public health concern due to its increased risks for maternal-fetal health. The present study aimed to characterize the risk knowledge of primiparous women of advanced age and their partners and to examine interindividual variability on risk knowledge depending on sociodemographic and reproductive characteristics. The study also examined the influence of one partner's risk knowledge on both partners' psychological distress.
The present study is part of an ongoing longitudinal project focusing on 2 timings of assessment: the prenatal diagnosis visit (time 1) and the third trimester of pregnancy (time 2). A total of 95 primiparous women of advanced age and their partners were consecutively recruited in a Portuguese referral urban hospital. Participants completed a questionnaire on knowledge of maternal age-related risks of childbearing at time 1 as well as the Brief Symptom Inventory-18 at time 2.
Both partners showed incomplete risk knowledge, with the exception of the impact of maternal age on fertility, the probability to request medical help to conceive, and increased risk of Down syndrome. Women's risk knowledge did not vary depending on sociodemographic and reproductive characteristics. Male partners with prior infertility and medically assisted reproduction treatments reported higher risk knowledge. Higher risk knowledge in male partners increased psychological distress during pregnancy in both members of the couples.
The findings indicated that first childbirth at advanced maternal age is rarely an informed reproductive decision, emphasizing the need to develop preventive interventions that may enhance couples' knowledge of maternal age-related risks. Given the influence of the risk knowledge of male partners on women's psychological distress, antenatal interventions should be couple-focused. Interventions should inform couples about maternal age-related risks, enhance their perceived control, and promote effective dyadic communication and coping strategies to address risk.
高龄产妇的首次分娩因其对母婴健康的风险增加，已成为一个日益受到关注的公共卫生问题。本研究旨在描述高龄初产妇及其伴侣的风险知识特征，并根据社会人口学和生殖特征研究风险知识的个体差异。该研究还考察了一方伴侣的风险知识对双方心理困扰的影响。
本研究是一个正在进行的纵向项目的一部分，重点关注两个评估时间点：产前诊断就诊时（时间1）和妊娠晚期（时间2）。在葡萄牙一家城市转诊医院连续招募了95名高龄初产妇及其伴侣。参与者在时间1完成了一份关于产妇年龄相关生育风险知识的问卷，并在时间2完成了简短症状量表-18。
双方伴侣的风险知识均不完整，但产妇年龄对生育力的影响、寻求医疗帮助受孕的可能性以及唐氏综合征风险增加除外。女性的风险知识不因社会人口学和生殖特征而有所不同。有过不孕史和接受过医学辅助生殖治疗的男性伴侣报告的风险知识更高。男性伴侣较高的风险知识增加了夫妻双方在孕期的心理困扰。
研究结果表明，高龄产妇的首次分娩很少是一个经过充分了解的生育决定，强调需要制定预防性干预措施，以增强夫妻对产妇年龄相关风险的认识。鉴于男性伴侣的风险知识对女性心理困扰的影响，产前干预应以夫妻为重点。干预措施应告知夫妻产妇年龄相关的风险，增强他们的感知控制能力，并促进有效的二元沟通和应对风险的策略。
