The relationship of maternal attitude to pregnancy outcomes and obstetric complications. A cohort study of unwanted pregnancy.

The relationships of maternal attitude to pregnancy outcome and obstetric complications were investigated in a prospective study of a group of 8,000 gravidas, enrolled in the Child Health and Development Studies, who were members of the Kaiser Foundation Health Plan in the San Francisco East Bay Area. Interviews which were conducted early in pregnancy determined the mother's attitude through an open-ended question, "How do you feel about having a baby now?" The responses to this question were categorized as strongly favorable, ambivalent, or negative. Biomedical factors which were related to negative maternal attitude were perinatal death, congenital anomalies, and postpartum infection or hemorrhage. Other factors which were found to be related to maternal attitude toward pregnancy were clinic visits for psychosocial complaints related to anxiety states, and accidental injuries during pregnancy, as well as need for analgesics during labor. Birth weight of the infant, duration of gestation, length of labor, prenatal complications, and intrapartum obstetric complications were not related to maternal attitude. In order to control for the effect of confounding factors, these relationships were analyzed by using a multicontingency table approach and stratifying the data by parity, age of mother, and socioeconomic status.