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    Pregnancy Intention in Relation to Nonplanning Impulsivity

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    Authors
    Godiwala, Prachi
    Appelhans, Bradley M.
    Moore Simas, Tiffany A.
    Xiao, Rui Sherry
    Liziewski, Kathryn E.
    Pagoto, Sherry L.
    Waring, Molly E.
    Faculty Advisor
    Molly E. Waring, PhD
    UMass Chan Affiliations
    Division of Behavioral and Preventive Medicine, Department of Medicine
    Department of Obstetrics and Gynecology
    Department of Quantitative Health Sciences
    Senior Scholars Program
    School of Medicine
    Document Type
    Poster
    Publication Date
    2015-04-29
    Keywords
    impulsivity
    long-active reversible contraceptives
    pregnancy intention
    unplanned pregnancy
    Behavior and Behavior Mechanisms
    Obstetrics and Gynecology
    Women's Health
    
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    Abstract
    Introduction: Half of pregnancies in the United States are unintended. We examine a novel risk factor for unintended pregnancies, impulsivity. We hypothesize that women with higher nonplanning impulsivity will be more likely to have an unplanned pregnancy. Methods: The parent study was a prospective cohort study of 125 pregnant women examining the association between impulsivity and weight gain during pregnancy. At an in-person study visit, women completed self-report measures via a secure web form. The 15-item Barratt Impulsiveness Scale (BIS-15) measures impulsivity using subjective statements about the respondent’s behavior with 4 response options: rarely/never, occasionally, often, and almost always/always. Three subscales with 5 questions each measure attention, motor, and nonplanning impulsivity. We categorized women as being less impulsive (subscale score of 5-10) versus more impulsive (11-20). We chose this cutoff as a score of 10 indicates responses of “never/rarely” or “occasionally”, representing lower impulsivity. Pregnancy intention was measured by asking women “When you got pregnant, were you trying to get pregnant?” (yes or no). Results: 34% reported that the current pregnancy was unplanned. 10% of women had high motor impulsivity, 21% high attention impulsivity, and 32% high nonplanning impulsivity. Women who were aged 18-24, obese, less educated, not married, of a lower socioeconomic status, and multigravid were more likely to have higher nonplanning impulsivity. 51% with high nonplanning impulsivity reported unplanned pregnancy compared to 25% (low nonplanning impulsivity). Women with high nonplanning impulsivity had 3.53 times the odds of unplanned pregnancy compared to women with low nonplanning impulsivity (adjusted for other 2 subscales and confounders; 95% CI: 1.23-10.14). Neither motor nor attention impulsivity was associated with pregnancy intention. Conclusions: Women with higher levels of nonplanning impulsivity are at higher risk of having unplanned pregnancies. The 5-item nonplanning subscale of the BIS-15 may help to identify women with high nonplanning impulsivity clinically; women could complete this brief measure prior to office visits, and these scores could direct contraception counseling. Contraception that requires little maintenance and no decision-making at the time of sexual encounters, such as long-acting reversible contraceptives (LARCs), may potentially lower unplanned pregnancy rates among more impulsive women. Further research should focus on creating a framework to identify these women, implementing a screening tool in the clinical setting, and to explore whether increasing LARC use in this population can lower unplanned pregnancy rates.
    DOI
    10.13028/p9d9-rb79
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/49299
    Notes

    Prachi Godiwala participated in this study as a medical student as part of the Senior Scholars research program at the University of Massachusetts Medical School. This poster was presented on Senior Scholars Program Poster Presentation Day at the University of Massachusetts Medical School, Worcester, MA, on April 29, 2015.

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    ae974a485f413a2113503eed53cd6c53
    10.13028/p9d9-rb79
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