(861) Dispositional optimism is associated with adverse pregnancy outcomes

Friday, February 10, 2023

10:30 AM – 12:00 PM

Objective: Dispositional optimism (the tendency to expect positive outcomes after personal challenges), is a transdiagnostic resilience factor associated with widespread health benefits including reduced mortality. Our objective was to evaluate whether early pregnancy dispositional optimism (DO) was associated with perinatal outcomes.

Study Design: This prospective cohort included nulliparous parturients recruited between 5/2019-2/2022 from a single, high volume center. Participants completed an assessment of dispositional optimism (the validated Revised Life Orientation Test) at < 20 weeks’ gestation, and were followed longitudinally. Detailed pregnancy and delivery data were collected by trained research personnel. The primary outcome was a composite of adverse perinatal outcomes (APO-- including gestational diabetes, hypertensive disorder of pregnancy, and cesarean delivery). Bivariable analyses compared APO by optimism score quartile. Multivariable logistic regression compared APO by continuous DO score per 5-point change, controlling for confounders that were significant in bivariable analyses.

Results:

Of the 300 parturients, the median DO score was 16.0 (IQR 14-18) and 47.6% experienced an APO. There were significant differences in participant characteristics stratified by DO quartile (Table 1). After adjusting for confounders, each 5-point increase in DO was associated with a 38% reduction in odds of the composite APO (aOR 0.62, 95% CI 0.41 – 0.92), driven by a decrease in cesarean.

Conclusion: Increasing DO was associated with a reduction in the odds of APO. Thus, interventions targeting improvements in DO may be a novel mechanism for reducing perinatal morbidity.

Primary & Presenting Author(s)

Nina K. Ayala, MD
Attending Physician
Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States

Coauthor(s)

Audra Fain, BS (she/her/hers)
Medical Student
Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States
Tess E.K Cersonsky, BS (she/her/hers)
Medical Student
Alpert Medical School of Brown University
Providence, Rhode Island, United States
Erika F. Werner, MD
Associate Professor, MFM Division Director
Women & Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University
Providence, Rhode Island, United States
Emily S. Miller, MD, MPH (she/her/hers)
Director, Division of Maternal-Fetal Medicine
Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island
Providence, Rhode Island, United States
Adam K. Lewkowitz, MD, MPHS
Assistant Professor
Alpert Medical School of Brown University and Women & Infants Hospital of Rhode Island
Providence, Rhode Island, United States