Abstract
Background: Women aged 35 and older account for an increasing proportion of births and are at increased risk of pregnancy complications and poor infant outcomes. The objectives of the study were: 1) to determine what women know about delayed childbearing, including pregnancy complications and outcomes associated with low birthweight (LBW, <2500 grams), preterm delivery (<37 weeks) and multiple birth, and 2) to assess the characteristics of women with limited knowledge of risks.
Methods: A computer-assisted telephone interview survey was conducted with 1,044 randomly selected women who delivered their first live-born infant, between July 2002 and September 2003, in two urban centres, Calgary and Edmonton, in Alberta, Canada.
Results: The proportion of women aware of specific childbearing risks associated with advanced maternal age were as follows: conception difficulties (85.3%), multiple birth (24.0%), caesarean section (18.8%), preterm delivery (21.8%), and LBW (11.2%). Knowledge of specific developmental and health-related risks of suboptimal infant outcomes ranged between 18.0% and 46.5%. Logistic regression revealed that limited knowledge of maternal age-related pregnancy risks were associated with unplanned pregnancy (OR, 1.48; 95% CI, 1.03–2.14), smoking (OR, 1.83; 95% CI, 1.29–2.60) and non-use of fertility treatment (OR, 2.15; 95% CI, 1.44–3.19). Characteristics associated with limited knowledge of the risks associated with suboptimal birth outcomes were: age 35–39 years (OR, 2.98; 95% CI, 1.35–6.58), less than post-graduate education (<high school OR, 2.14; 95% CI, 1.20–3.82), and not currently enrolled as a student (OR, 1.75; 95% CI, 1.02–3.00).
Conclusions: Many women are generally unaware of the potential consequences of delayed childbearing. There are missed opportunities in preconception counselling and education, which should be addressed to allow for more informed decision-making about family planning.
MeSH terms: Pregnancy, reproductive behaviour, health knowledge
Résumé
Contexte: Une proportion croissante de bébés naissent de femmes de 35 ans et plus, lesquelles risquent davantage d’avoir des complications durant la grossesse et d’accoucher de nourrissons d’un poids sous-optimal. Notre étude visait: 1) à déterminer ce que les femmes savent au sujet de la procréation tardive, notamment des complications de la grossesse et des résultats associés à l’insuffisance de poids à la naissance (IPN, <2 500 g), à l’accouchement prématuré (<37 semaines) et à l’accouchement multiple, et 2) à évaluer les caractéristiques des femmes qui connaissent mal ces risques.
Méthode: Nous avons mené un sondage téléphonique assisté par ordinateur auprès de 1 044 femmes, sélectionnées au hasard, ayant accouché d’un premier enfant vivant entre juillet 2002 et septembre 2003 dans deux centres urbains de l’Alberta (Calgary et Edmonton).
Résultats: Les femmes connaissaient les risques de la procréation à un âge avancé dans les proportions suivantes: difficultés à concevoir (85,3 %), accouchement multiple (24 %), accouchement par césarienne (18,8 %), accouchement prématuré (21,8 %), et IPN (11,2 %). Entre 18 % et 46,5 % des répondantes connaissaient les risques développementaux et sanitaires auxquels est exposé un nouveau-né de poids sous-optimal. Une analyse de régression logistique a montré que la connaissance limitée des risques de la grossesse à un âge maternel avancé était associée à la grossesse non planifiée (RC = 1,48; IC de 95 % = 1,03–2,14), au tabagisme (RC = 1,83; IC de 95 % = 1,29–2,60) et au fait de ne pas avoir subi de traitement de l’infertilité (RC = 2,15; IC de 95 % = 1,44–3,19). Les caractéristiques associées à la connaissance limitée des risques de l’IPN étaient les suivantes: avoir entre 35 et 39 ans (RC = 2,98; IC de 95 % = 1,35–6,58), ne pas avoir fait d’études postsecondaires (moins qu’un diplôme d’études secondaires: RC = 2,14; IC de 95 % = 1,20–3,82), et ne pas être inscrite en tant qu’étudiante (RC = 1,75; IC de 95 % = 1,02–3,00).
Conclusions: Nombre de femmes ont peu conscience des répercussions possibles de la procréation tardive. Il y aurait des lacunes à combler sur le plan du counselling et de l’éducation avant la grossesse pour favoriser une prise de décisions plus éclairée en matière de planning familial.
Footnotes
Source of funding: Alberta Heritage Foundation for Medical Research
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