The delay of motherhood: Reasons, determinants, time used to achieve pregnancy, and maternal anxiety level

English version

Autoři: Leticia Molina-García ^aff001; Manuel Hidalgo-Ruiz ^aff002; Eva María Cocera-Ruíz ^aff003; Esther Conde-Puertas ^aff003; Miguel Delgado-Rodríguez ^aff004; Juan Miguel Martínez-Galiano ^aff005
Působiště autorů: Department of Obstetrics and Gynecology, Complejo Hospitalario de Jaén, Andalucia, Jaén, Spain ^aff001; Department of Obstetrics and Gynecology, Hospital San Juan de la Cruz, Andalucia, Úbeda, Spain ^aff002; Department of Obstetrics and Gynecology, Hospital San Agustín, Andalucia, Linares, Spain ^aff003; Department of Health Sciences, University of Jaén, Andalucia, Jaén, Spain ^aff004; Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Comunidad de Madrid, Madrid, Spain ^aff005; Department of Nursing, University of Jaén, Andalucia, Jaén, Spain ^aff006
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: https://doi.org/10.1371/journal.pone.0227063

Souhrn

Background

Fertility in recent decades in European countries such as Norway, Spain or United Kingdom has declined, while in others such as Portugal, it has remained relatively constant, and in others such as Germany fertility rated have risen. The determinants of this change in reproductive pattern can be explained by the cultural, social, and economic changes that took place in our society. Objective: to identify the principal reasons and independent determinants associated with the postponement of motherhood and document any association between the time taken to achieve successful pregnancy and maternal age, as well as the level of anxiety of these women.

Methods

An observational study, including 326 women, was conducted in Spain with primiparous women, in which data was collected on sociodemographic, health, and pregnancy-related factors. Comparison of means (t-test or analysis of variance) and the analysis of covariance was used to estimate adjusted means for potential confounders.

Results

Women in stable relationships became mothers at older ages (31.83±0.29) than those who were not (28.75±0.78) (p<0.001). Women who delayed motherhood for medical reasons had a mean age of 34.15 ± 0.88 years, compared to a mean of 30.52±0.36 years for personal reasons, and 27.51±1.39 years for other reasons. Mothers with an older age had a higher level of anxiety (p<0.05). The average time required to achieve pregnancy increased as maternal age increased, with an average time of 24 months for women with a mean age of 35.23±0.71 years compared to <3 months for women with a mean age of 29.44±0.39 years. Women ≥ 35 years were more likely to need medical assistance to achieve pregnancy (aOR = 12.07, 95% CI: 1.50–97.05; p = 0.019).

Conclusions

Medical reasons were among those cited for delaying motherhood. The postponement of motherhood was associated with difficulty to achieve a successful pregnancy and a higher level of anxiety.

Klíčová slova:

Educational attainment – Employment – Labor and delivery – Medical education – Miscarriage – Mothers – Obstetrics and gynecology – Pregnancy

Zdroje

1. Legazpe Moraleja N. Decisiones de formación de la pareja y maternidad en las mujeres españolas. Revista de Economía Aplicada. 2016, 24(72), 23–45.

2. Heras Pérez B.; Gobernado Tejedor J.; Mora Cepeda P.; Almaraz Gómez A. La edad materna como factor de riesgo obstétrico. Resultados perinatales en gestantes de edad avanzada. Prog. Obs. Ginecol. 2011, 54(11), 575–580.

3. Monleón Sancho J.; Baixauli C.; Minguez Milio J.; García Román N.; Plana A.; Monleón J. El concepto de primípara añosa. Prog. Obs. Ginecol. 2002, 45(9), 384–390

4. Stufflebeam D.; Shinkfield JA. Evaluación Sistemática, Guía Teórica y Práctica, 1a ed.; Paidós Ibérica, Madrid, 1987.

5. Sociedad Española de Ginecología y Obstetricia. Recomendaciones sobre la asistencia al parto. 2007. http://www.perinatalandalucia.es/file.php?file=%2F20%2F29.Recomendaciones_SEGO_asistencia_parto_normal.pdf (Accessed: 1 Junio, 2018).

6. Gindoff P.R.; Jewelewicz R. Reproductive potential in the older woman. Fertil Steril. 1986, 46(6), 989–1001 doi: 10.1016/s0015-0282(16)49869-9 3536609

7. Martínez Galiano J.M. La maternidad en madres de 40 años. Rev cub. salud pública. 2016, 42 (3), 451–458.

8. Molina García L.; Hidalgo Ruiz M.; Arredondo López B.; Colomino Ceprián S.; Delgado Rodríguez M.; Martínez Galiano J.M. Maternal Age and Pregnancy, Childbirth and the Puerperium: Obstetric Results. J. Clin. Med. 2019, 8, 672.

9. Molina-García L, Hidalgo-Ruiz M, Cámara-Jurado AM, Fernández-Valero MJ, Delgado-Rodríguez M, Martínez-Galiano JM. Newborn Health Indicators Associated with Maternal Age during First Pregnancy. International Journal of Environmental Research and Public Health. 2019; 16(18):3448.

10. Barros Delgadillo C.J.; Castañeda Tenorio M.; Aguayo González P.; Muñoz Manrique C. Consecuencias perinatales de embarazos logrados mediante reproducción asistida versus embarazos espontáneos. Ginecol. Obstet. Mex. 2018, 86(11), 732–731.

11. Donoso E.; Carvajal J.A.; Vera C.; Poblete J.A. La edad de la mujer como factor de riesgo de mortalidad materna, fetal, neonatal e infantil. Rev. méd. Chile. 2014, 142, 168–174. doi: 10.4067/S0034-98872014000200004

12. Fernández O.; Masoli I. Fertilidad después de los 40 años. Rev. méd. Clín. Las Condes. 2009, 20(1), 16–21.

13. Schmidt L.; Sobotka T.; Bentzen J.G.; Nyboe A. Demographic and medical consequences of the postponement of parenthood. Hum Reprod Update. 2012, 18(1), 29–43 doi: 10.1093/humupd/dmr040 21989171

14. Balasch J.; Gratacós E.; Delayed childbearing: effects on fertility and the outcome of pregnancy. Curr Opin Obstet Gynecol. 2012, 24(3), 187–93. doi: 10.1097/GCO.0b013e3283517908 22450043

15. Instituto Nacional de Estadística. Demografía y población: Encuesta de Fecundidad. 2018 https://www.ine.es/dyngs/INEbase/es/operacion.htm?c=Estadistica_C&cid=1254736177006&menu=ultiDatos&idp=1254735573002 (Accessed: 1 Marzo, 2019).

16. Alamillos Guardiola M.C. La maternidad tardía: expresión contemporánea del patriarcado occidental. Rev. Antropol. Exp. 2016, 16: 213–221. Disponible en línea: https://dx.doi.org/10.17561/rae.v0i16.2241 (se accede en el 12 de Abril de 2019).

17. Montilva M. Postergación de la maternidad de mujeres profesionales jóvenes en dos metrópolis latinoamericanas. Utopìa y Praxis Latinoamericana. 2008, 13(41), 69–79.

18. Nunes Lopes M.; Lovato Dellazzana-Zanon L.; Gonçalves Boeckel M. A multiplicidade de papéis da mulher contemporânea e a maternidade tardia. Temas psicol. 2014, 22(4), 917–928.

19. Ní Bhrolcháin M.; Beaujouan E. Fertility postponement is largely due to rising educational enrolment. Popul Stud. 2012, 66 (3), 311–327.

20. Correia S.; Rodrigues T.; Barros H. Socioeconomic variations in female fertility impairment: a study in a cohort of Portuguese mothers. BMJ Open. 2014, 4(1).

21. Manzur A.; Macaya R.; Gajardo G. Inseminación intrauterina en mayores de 38 años, ¿vale la pena?. Rev. peru. ginecol. obstet. 2012, 58 (1), 11–16.

22. Fitzpatrick K.E.; Tuffnell D.; Kurinczuk J.J.; Knight M. Pregnancy at very advanced maternal age: a UK population-based cohort study. BJOG. 2017, 124(7), 1097–1106. doi: 10.1111/1471-0528.14269 27581343

23. Ginar da Silva S.; Dâmaso Bertoldi A.; Freitas da Silveira M.; Rodrigues Domingues M.; Evenson K.R.; Silva dos Santos I. Assisted reproductive technology: prevalence and associated factors in Southern Brazil. Rev Saúde Pública. 2019, 53, 13. doi: 10.11606/S1518-8787.2019053000737 30726494

24. Dennis CL, Falah-Hassani K, Shiri R. Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry. 2017 May;210(5):315–323. doi: 10.1192/bjp.bp.116.187179 28302701

25. Dunkel-Schetter C. Psychological science on pregnancy: stress processes, biopsychosocial models, and emerging research issues. Annu Rev Psychol 2011;62:531–558 doi: 10.1146/annurev.psych.031809.130727 21126184

26. Romero-Gutiérrez G, Rocha-Morales D, Ruiz-Treviño AS. Resultados de la aplicación de la escala de Hamilton modificada en el diagnóstico de ansiedad materna durante el puerperio inmediato. Ginecol Obstet Mex 2013;81:180–185

27. Giardinelli L, Innocenti A, Benni L, Stefanini MC, Lino G, Lunardi C, et al. Depression and anxiety in perinatal period: prevalence and risk factors in an Italian sample. Arch Womens Ment Health. 2012 Feb;15(1):21–30. doi: 10.1007/s00737-011-0249-8 22205237

28. Vázquez Valverde C.; Jiménez Franco F. Depression and mania. In Clinical Measurement in Psychiatry and Psychology, 1a ed.; Bulbuena Vilarrasa A., Berrios G.E., Fernández de Larrinoa Palacios P., eds.; Barcelona, Spain, 2003.

29. Martinez-Galiano JM, Delgado-Rodriguez M. La educación maternal como recurso para reducir la ansiedad que genera la proximidad del proceso de parto, Revista argentina de clinica psicológica, 2014, 23, (3), 261–266.

30. Beets G. The Demography of the Age at First Birth: The Close Relationship between Having Children and Postponement. En The Future of Motherhood in Western Societies. Beets G., Schippers J., te Velde E. eds.; New York, 2010.

31. Mills M.; Rindfuss R.; McDonald P.; te Velde E. Why do people postpone parenthood? Reasons and social policy incentives. Hum Reprod Update. 2011, 17(6), 848–860. doi: 10.1093/humupd/dmr026 21652599

32. Sobotka T. Shifting parenthood to advanced reproductive ages: Trends, causes and consequences. En A Young Generation Under Pressure? Financial situation and ‘rush hour of life’ of the cohorts 1970–1985 in a generational comparison, 1a ed.; BerlinHeidelberg, Springer-Verlag; 2010, pp. 129–154.

33. Esteve, A.; Devolder, D.; Domingo, A. La infecundidad en España: tic-tac, tic-tac, tic-tac!!!. Bellaterra Centre d'Estudis Demogràfics. 2016.

34. López Garrido B.; Gil Pita R.; García Alfaro M.; Varela Quintela L.; García Ruiz N. Tiempo medio en alcanzar un embarazo deseado y factores influyentes. Matronas profesión. 2013, 14 (3–4), 74–81.

35. Moreno Rosset C.; Antequera Jurado R.; Jenaro Río C.; Gómez Sánchez Y. La Psicología de la Reproducción: la necesidad del psicólogo en las Unidades de Reproducción Humana. Clínica y Salud. 2009, 20(1), 79–90.

36. Fisher J.; Wynter K.; Hammarberg K.; McBain J.; Gibson F.; Boivin J.; et al. Age, mode of conception, health service use and pregnancy health: a prospective cohort study of Australian women. BMC Pregnancy Childbirth. 2013, 13, 88. doi: 10.1186/1471-2393-13-88 23565589

37. Barros Delgadillo C.J.; Castañeda Tenorio M.; Aguayo González P.; Muñoz Manrique C. Consecuencias perinatales de embarazos logrados mediante reproducción asistida versus embarazos espontáneos. Ginecol Obstet Méx. 2018, 86(11), 732–731

38. Velásquez, A. Ansiedad y depresión en primigestas adolescentes y añosas según la edad gestacional. Tesis doctoral, Universidad Central de Venezuela, Caracas. 1995

39. Van Heyningen T.; Honikman S.; Myer L.; Onah M.N.; Field S.; Tomlinson M. Prevalence and predictors of anxiety disorders amongst low-income pregnant women in urban South Africa: a cross-sectional study. Arch Womens Ment Health. 2017, 20(6), 765–775. doi: 10.1007/s00737-017-0768-z 28852868

40. Lardon E, St-Laurent A, Babineau V, Descarreaux M, Ruchat SM. Lumbopelvic pain, anxiety, physical activity and mode of conception: a prospective cohort study of pregnant women. BMJ Open. 2018;8(11):e022508. doi: 10.1136/bmjopen-2018-022508 30389759

41. Darwiche J, Milek A, Antonietti JP, Vial Y. Partner support during the prenatal testing period after assisted conception. Women Birth. 2019 Apr;32(2):e264–e271. doi: 10.1016/j.wombi.2018.07.006 30100195

The delay of motherhood: Reasons, determinants, time used to achieve pregnancy, and maternal anxiety level

Souhrn

Background

Methods

Results

Conclusions

Klíčová slova:

Zdroje

PLOS One

Svět praktické medicíny 3/2024 (znalostní test z časopisu)

Kardiologické projevy hypereozinofilií

Střevní příprava před kolonoskopií

Aktuální možnosti diagnostiky a léčby litiáz

Závislosti moderní doby – digitální závislosti a hypnotika