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. 2023 Dec;17(6):1660-1668.
doi: 10.1007/s11764-022-01281-1. Epub 2022 Oct 27.

The effect of changing pregnancy intentions on preconception health behaviors: a prospective cohort study

Hena Naz Din  1   2 , David Strong  3   4 , Savitri Singh-Carlson  5 , Heather L Corliss  6   7 , Sheri J Hartman  3   4 , Hala Madanat  6   8   9 , H Irene Su  10
Affiliations

The effect of changing pregnancy intentions on preconception health behaviors: a prospective cohort study

Hena Naz Din et al. J Cancer Surviv. 2023 Dec.

Abstract

Purpose: Pregnancy intentions are associated with preconception health behaviors but are understudied among female adolescent and young adult (AYA) cancer survivors. Preconception health is critical for survivors because they face unique risks to fertility and pregnancy from late effects of cancer treatments. This study prospectively assessed the effect of pregnancy intention on physical activity (PA) and smoking behaviors among female AYA survivors.

Methods: A cohort of 1049 female AYA survivors were recruited between 2013 and 2017. Participants were 18-39 years and had completed primary cancer treatment. Longitudinal mixed effects analysis was conducted on participants who completed at least 2 of 4 questionnaires over 1.5 years. Two measures were used to capture multiple dimensions of pregnancy intention. The pregnancy intention score (PIS) captured wanting and planning dimensions and represented a scaled response of low to high intention. The trying dimension captured urgent intention and ranged from not trying, ambivalent (neither attempting nor avoiding pregnancy), and trying now. Intention change was assessed between each consecutive time points. Final analysis was conducted with multiple imputations.

Results: Survivors with increased intention measured by trying was associated with increased PA over time (adjusted B [95%CI]: 0.3 [0.01, 0.5]) compared to survivors with no changes or decreased trying intention. PIS was not significantly associated with preconception behaviors. No measure of intention was associated with smoking behavior.

Conclusions: Increasingly urgent pregnancy intention (trying dimension) was associated with higher preconception PA.

Implications for cancer survivors: Screening for immediate intentions can identify AYA survivors in need of early preconception health promotion.

Keywords: Adolescent and young adult cancer; Physical activity; Preconception health; Pregnancy intention; Smoking; Survivorship care.

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Conflict of interest statement

Irene Su received a symposium honorarium from Ferring Pharmaceuticals. No other authors have any competing interests

HIS received a symposium honorarium from Ferring Pharmaceuticals. All other authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Number of participants at each study time point, who were included in the study cohort, were missing, or were excluded due to an existing pregnancy or reported breastfeeding
Fig. 2
Fig. 2
Sample mean and 95% CI of the pregnancy intention score (left) and proportions of the trying pregnancy intention (right) over time
See this image and copyright information in PMC

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