Obsessional symptoms in expectant women and outcome of their pregnancy.

The aim of this investigation was to explore whether, within the scope of personality traits and their modifications during pregnancy, the obsessional dimension may have a protective role against premature birth. In fact, obsessional characterology with its tendency to control may suggest that the women with these traits do not passively experience their pregnancy and may try to control its evolution, at least in their fantasies. Personality dimensions have been recorded using Derogatis' psychological self-administered questionnaire, in which women were asked to assess their level on the Derogatis symptom scale before and during pregnancy. The survey involved 351 women (117 premature and 234 term deliveries) who had both completed the self-administered questionnaire on the 6-month pregnancy visit and answered a specific interview at birth. Our results have shown that the existence of obsessional traits before pregnancy apparently does not have a protective role against premature delivery (odds ratio = 1.40; NS). Conversely, intensified obsessional symptoms during pregnancy are associated with a decreased premature birth rate (odds ratio = 0.44; p < 0.05). These results remain when the presence of obsessional traits before pregnancy is taken into account (adjusted odds ratio = 0.38; p < 0.02). The possibility of a defence reaction to this situation of pregnancy is discussed.

Development and use of a self-administered questionnaire for assessment of psychologic attitudes toward pregnancy and their relation to a subsequent premature birth.

This paper describes both the development of and results of the use of a self-administered questionnaire designed specifically to investigate the relation between the psychologic attitudes of pregnant women toward pregnancy and an eventual subsequent premature birth. The questionnaire (entitled Pregnancy Psychologic Attitudes Test--in relation to Premature Birth [PPAT(p)]) was derived from the synthesis of interviews with women who had given birth prematurely, comprised 40 questions grouped in six dimensions, and was used in a prospective survey. All women who had an antenatal visit in their fifth to sixth month of pregnancy in one of four maternity hospitals in Lyon, France, between October 1983 and March 1985 were asked to complete this questionnaire. A quantitative PPAT(p) score (ranging from 0 to 6) was constructed in a working sample (n = 643), and its relation with a subsequent premature birth was analyzed in a study sample (n = 1,500). Application of the logistic regression model showed, after controlling for personal and medical factors, that this relation was statistically significant. The risk of premature birth increased from 1 to 1.5 when the PPAT(p) score increased one point (p less than 0.001). This study contributes to a better understanding of psychologic factors that may affect pregnant women and be associated with premature birth. This new component must be considered in the development of policies for preventing premature birth.

[Contraceptive methods and women's age]. / Pratiques contraceptives et age des femmes.

PIP: 1582 women aged 15-44 in the area of Lyon, France, were interviewed by a psychologist in 1981-82 concerning their attitudes to contraceptives. Many women were more approving or tolerant of specific contraceptive methods for other women than for themselves. 72% approved of sterilization for other women but only 55% stated they would consider it for themselves. 88% of respondents stated they had ever used contraception, with the proportion increasing by age from 55% of those under 20 years old to 95% of those over 30. Among the 1392 women having ever used a contraceptive method, 14% said they did not like any method. 70% liked the pill, 60% liked the OC, and 25-35% liked various periodic abstinence methods. Attitudes toward different methods varied by age. Use of methods also varied by age. The most recent method used within the past year varied from 68% of women under 20 to 32% over 35 for the pill, from under 7% for women 20-29 to 20% for women 30-35 for the IUD, from about 11% of all women to 14% among women aged 30-34 for natural and mechanical methods, and from 3.5% of women 30-34 to 15% of those over 35 for female sterilization. Use of IUDs and OCs declined with parity but increased for women living alone or in consensual unions. Use of OCs and IUDs was lowest among women in households headed by workers in low level jobs. Within each parity, marital status, age, or employment group, use of OCs and IUDs declined with age. The decline in use of IUDs and OCs by age when number of children, marital status, and socioprofessional category were controlled was confirmed by regression analysis.^ieng

Sociodemographic characteristics and intentions for further births in France.

PIP: The purpose of this study, which interviewed 356 couples of childbearing age in the Lyon region of France, was to analyze the different attitudes of men and women towards parenthood, and to identify the social and personal characteristics which may modify these attitudes. The 2 groups in the study, the 183 couples who wanted an additional child and the 127 who did not, were compared in relation to socioeconomic status, woman's work status, woman's age at 1st birth, and absence of a child of each sex. (46 couples with conflicting intentions were excluded.) The couples intending to have further children on average had significantly fewer children, were younger, and less frequently had a child of each sex. The other factors were statiscally insignificant. The fertility rate of couples not wanting more children was above the replacement rate of 2.6. The rate for couples intending to have another child was comparable at 2.4, except that the average 5 year age differences between the 2 groups was higher than the usual interval between 2 births, reinforcing the trend toward a model family of 2 or 3 children and greater intervals between consecutive births.^ieng

[Behavior of men and women with respect to procreation]. / Comportement des hommes et des femmes face à la procréation.

A specific survey was carried out on a sample of men and women of childbearing age to study their attitudes towards parenthood and to analyse psycho-social aspects which may have an effect thereon. The analysis took into account; the children number, woman's age, socio-economic status and occupational activity. Whatever the factor studied, it was constantly observed that the demand for an additional child (in particular the third child) was expressed more often by men than by women.

[Risk factors of prematurity related life style. Apropos of INSERM surveys in the Rhone-Alpes area]. / Facteurs de risque de prématurité liés au mode de vie. A propos des enquêtes de l'INSERM dans la région Rhône-Alpes.

Based on INSERM epidemiological surveys, the authors study the risk of prematurity related to the maternal way of life. The prematurity rate is higher in women younger than 20 years, in women of foreign overseas origin, in unmarried women living in couple or alone, and in women of low socio-economic classes. Work during pregnancy is not in itself a risk factor as women at home present a higher prematurity rate than women at work. However, the strenuous working conditions, which concern about 20% of pregnant women at work, lead to a higher prematurity rate. Other factors such as smoking, alcohol consumption, travelling and housework are studied. The role of psychological modifications linked to pregnancy is discussed, particularly in women who do not present any medical factor. From these data, suggestions are made in order to improve prematurity prevention.

[Construction of questionnaires for the study of psychological components in the etiology of somatic diseases. The example of prematurity]. / Construction de questionnaires pour la recherche de composantes psychologiques dans l'étiologie de maladies somatiques. Exemple de la prématurité.

A study whose aim was to define the role of psychological factors in prematurity etiology has led us to develop a methodology for evaluation of personality which could have a connection with the occurrence of a premature birth. The proposed method--interviews based on free association followed by the construction of questionnaires serving as a base for an epidemiological study--seem to us applicable in order to show the psychological components which intervene in the occurrence of a somatic illness.