Department of Obstetrics, Gynecology and Reproductive Sciences, Advancing Standards in Reproductive Health (ANSIRH), University of California, School of Medicine, Oakland, California, USA
Department of Obstetrics, Gynecology and Reproductive Sciences, Advancing Standards in Reproductive Health (ANSIRH), University of California, School of Medicine, Oakland, California, USA.
BMJ Open. 2024 Sep 25;14(9):e085372. doi: 10.1136/bmjopen-2024-085372.
Significant methodological shortcomings limit the validity of prior research on pregnancy decision-making and the effects of 'unintended' pregnancies on people's health and well-being. The Attitudes and Decisions After Pregnancy Testing (ADAPT) study investigates the consequences for individuals unable to attain their pregnancy and childbearing preferences using an innovative nested prospective cohort design and novel conceptualisation and measurement of pregnancy preferences.
This paper describes the characteristics of the ADAPT Study Cohort, comprised of 2015 individuals aged 15-34 years, assigned female at birth, recruited between 2019 and 2022 from 23 health facilities in the southwestern USA.
The cohort was on average 25 years old. About 59% identified as Hispanic/Latine, 21% as white, and 8% as black, 13% multiracial or another race. Over half (56%) were nulliparous. About 32% lived in a household with income <100% of the federal poverty level. A significant minority (37%) reported a history of a depressive, anxiety or other mental health disorder diagnosis, and 30% reported currently experiencing moderate or severe depressive symptoms. Over one-quarter (27%) had ever experienced physical intimate partner violence, and almost half (49%) had ever experienced emotional abuse. About half (49%) had been diagnosed with a chronic health condition, and 37% rated their physical health as fair or poor. The 335 (17%) participants who experienced incident pregnancy over 1 year were similar to selected non-pregnant matched comparison participants in terms of age, racial and ethnic identity, and parity but were more likely to live with a main partner than comparison participants.
We will continue to follow participants who experienced incident pregnancy and non-pregnant comparison participants until 2026. Analyses will examine pregnancy decision-making and investigate differences in health and well-being by prepregnancy pregnancy desires and feelings after the discovery of pregnancy, offering new insights into the consequences of not attaining one's reproductive preferences.
NCT03888404.
先前关于怀孕决策以及意外怀孕对人们健康和幸福的影响的研究存在重大方法学缺陷，限制了其有效性。“怀孕测试后态度和决策（ADAPT）”研究采用创新的嵌套前瞻性队列设计和新颖的怀孕偏好概念化和测量方法，调查了无法实现怀孕和生育偏好的个体的后果。
本文介绍了 ADAPT 研究队列的特征，该队列由 2015 名年龄在 15-34 岁之间、出生时被指定为女性的个体组成，于 2019 年至 2022 年期间在美国西南部的 23 个医疗设施招募。
队列的平均年龄为 25 岁。约 59%的人自认为是西班牙裔/拉丁裔，21%的人自认为是白人，8%的人自认为是黑人，13%的人是多种族或其他种族。超过一半（56%）的人是初产妇。约 32%的人生活在收入低于联邦贫困线 100%的家庭中。相当一部分（37%）人报告有抑郁、焦虑或其他精神健康障碍的病史，30%的人报告目前有中度或重度抑郁症状。超过四分之一（27%）的人曾遭受过身体上的亲密伴侣暴力，近一半（49%）的人曾遭受过情感虐待。约一半（49%）的人被诊断患有慢性健康状况，37%的人自评身体健康状况为一般或较差。在 1 年内经历过意外怀孕的 335 名（17%）参与者在年龄、种族和民族认同以及生育次数方面与选定的未怀孕匹配对照组参与者相似，但与对照组参与者相比，这些参与者更有可能与主要伴侣生活在一起。
我们将继续随访经历过意外怀孕和未怀孕对照组参与者，直至 2026 年。分析将检查怀孕决策，并通过怀孕前的怀孕愿望和怀孕后的怀孕感受来研究健康和幸福的差异，为无法实现生殖偏好的后果提供新的见解。
NCT03888404。
