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Psychiatric vulnerability and unintended pregnancies

Projectomschrijving

MoMentUM studie: Onbedoelde zwangerschappen en family planning bij vrouwen met een psychiatrische kwetsbaarheid

Vraagstuk

Is psychiatrische kwetsbaarheid bij vrouwen een risicofactor voor onbedoelde zwangerschappen?

Onderzoek

In de "Maternal Mental Health and Unintended Motherhood" (MoMentUM)-study wordt door middel van dossieronderzoek het percentage onbedoelde zwangerschappen vergeleken tussen vrouwen met en zonder een psychiatrische kwetsbaarheid. Daarnaast zal er door middel van focusgroepen en diepte-interviews meer inzicht worden gekregen in welke factoren een rol spelen bij onbedoelde zwangerschap onder psychiatrisch kwetsbaren. Tenslotte zal er onder zorgverleners en (ex-)patiënten een enquête over het concept van ‘family planning’ in de Nederlandse psychiatrische praktijk worden uitgezet.

Verwachte uitkomst

De resultaten zullen helpen bij de ontwikkeling van vroege preventie en interventie strategieën. Ook zal het onderzoek leiden tot ontwikkeling van een ‘family check’: een gids die zorgprofessionals hulp biedt bij het bespreken van family planning hun patiënten.

Contact

Mocht u in contact willen komen met dit project, dan kunt u mailen naar: n.n.schonewille@olvg.nl.

Producten

Titel: Onbedoelde zwangerschappen bij vrouwen met en zonder psychiatrische diagnose: Preliminaire data van een Amsterdamse retrospectieve cohortstudie
Auteur: Noralie Schonewille
Titel: Psychische klachten en gezinsplanning: een ondergeschoven kindje?
Auteur: Noralie Schonewille
Titel: Psychische klachten en gezinsplanning: een ondergeschoven kindje?
Auteur: Noralie Schonewille en Monique van den Eijnden
Link: http://NA
Titel: Experiences with Family Planning amongst Persons with Mental Health Problems: A Nationwide Patient Survey
Auteur: by Noralie N. Schonewille, Monique J. M. van den Eijnden, Nini H. Jonkman, Anne A. M. W. van Kempen, Maria G. van Pampus, Francisca G. Goedhart, Odile A. van den Heuvel and Birit F. P. Broekman
Magazine: International Journal of Environmental Research and Public Health
Link: https://doi.org/10.3390/ijerph20043070
Titel: Psychiatric vulnerability and the risk for unintended pregnancies, a systematic review and meta-analysis
Auteur: N. N. Schonewille, N. Rijkers, A. Berenschot, J. G. Lijmer, O. A. van den Heuvel and B. F. P. Broekman
Magazine: BMC Pregnancy and Childbirth
Link: https://doi. org/10.1186/s12884-022-04452-1

Verslagen


Samenvatting van de aanvraag

One out of five Dutch women will become pregnant unintendedly (pregnancies that are not planned for, intended, and/or wanted as judged by the pregnant women in retrospect) in her life. Unintended pregnancies are associated with adverse maternal, obstetric, neonatal, and infant outcomes like premature birth, low birth weight and postpartum depression, which impact on quality of life and create high medical care expenses and costs for society over the years. Although it is well known that some demographic factors like young maternal age increase the risk for unintended pregnancies, the role of psychiatric vulnerability (a history of psychiatric disorders and/or current psychiatric problems) as a risk factor to become pregnant unintended is unclear. Although many studies showed adverse effects of psychiatric problems during pregnancy on obstetric and neonatal outcomes, as well as associations between unintended pregnancies and adverse obstetric and neonatal outcomes, studies on the risk for unintended pregnancies specifically in women with common psychiatric vulnerability are sparse, and in the Netherlands have never been conducted. This is remarkable since these studies could enable us to design strategies for early prevention. Therefore, in this study we aim to provide a comprehensive overview of unintended pregnancies amongst women with psychiatric vulnerability in the Netherlands, by conducting three work packages (WPs). We will take into account societal costs and impact of these unintended pregnancies. We will (WP1) gain insight in the incidence of unintended pregnancies amongst women with psychiatric vulnerability compared to women without a psychiatric vulnerability and compare (adverse) obstetric and infant outcomes between these groups, (WP2) explore underlying mechanisms that attribute to the development of unintended pregnancies in women with psychiatric vulnerabilities and (WP3) investigate current family planning strategies (if any) in psychiatric health care institutions. To reach these aims, in WP1 we will conduct a retrospective cohort study in OLVG, the largest maternity centre of Amsterdam, the Netherlands. In this study, pregnancy intendedness, obstetric and neonatal outcomes will be compared between approximately 1.500 women who are vulnerable for psychiatric disorders (such as a personality disorder or recurrent depression) of whom most have been seen at the Psychiatric Obstetric Paediatric Clinic (“POP-clinic”) and over 15.000 women without psychiatric vulnerabilities prior to their pregnancy, and who have been seen at the regular obstetric clinics of OLVG. Primary outcome is the presence of unintended pregnancies. The association between different psychiatric vulnerabilities (such as affective disorders, psychotic disorders, personality disorders etc.) and the incidence of unintended pregnancies within these various disorders will also be evaluated. We expect to demonstrate that women who are vulnerable for psychiatric disorders have a higher prevalence of unintended pregnancies than women without psychiatric vulnerability. Also, we hypothesize that women with a psychiatric vulnerability and unintended pregnancies have more and/or more serious adverse obstetric and neonatal outcomes than women with unintended pregnancies who lack psychiatric vulnerability. In addition, the costs of maternal and neonatal complications will be evaluated and recommendations for future care will be considered. On top of quantitative data assessment, in WP2 we will interview patients to gain insight in the underlying mechanisms that play a role in the relation between psychiatric vulnerability on unintended pregnancies. Also, in WP3 we plan to disperse questionnaires and interviews amongst both patients with psychiatric vulnerability and mental health care professionals, to assess the role of family planning (if any) in every day psychiatric care. Also, we will develop a “Family check”: a guide to help mental health professionals to discuss the topic of family planning with their patients. The above-mentioned WPs will contribute to the knowledge about the role of psychiatric vulnerability in relation to unintended pregnancies in the Netherlands and can help to develop early prevention and intervention strategies. This is in line with the research agenda of national and international movements like “Vertrouwen in de toekomst” by the Dutch government and the organization ‘Every woman, every child’ from the United Nations (prevention of unwanted pregnancies worldwide) that both underscore the importance of prevention of unintended pregnancies.

Kenmerken

Projectnummer:
554002007
Looptijd: 100%
Looptijd: 100 %
2021
2023
Gerelateerde subsidieronde:
Projectleider en penvoerder:
N.N. Schonewille
Verantwoordelijke organisatie:
OLVG