(354) Proactive coping in early pregnancy and adverse pregnancy outcomes

Thursday, February 9, 2023

10:30 AM – 12:00 PM

Objective: Proactive coping is associated with both mental and physical well-being outside of pregnancy. Whether proactive coping is associated with perinatal outcomes is unknown. Our objective was to quantify the association between early pregnancy proactive coping and perinatal outcomes.

Study Design: This is a planned secondary analysis of nulliparous parturients recruited between 5/2019-2/2022 from a single, high volume center. Participants completed a validated assessment of proactive coping (Proactive Coping Scale—PCS) at < 20 weeks 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: gestational diabetes, hypertensive disorders of pregnancy, and cesarean delivery). Secondary analyses included individual composite components. Bivariable analyses compared APO by Proactive Coping Inventory (PCI) quartile. Multivariate logistic regression compared APO by continuous PCI score in 5-point increments, controlling for confounders determined a priori from the literature.

Results: Of the 300 parturients, the median PCS score was 45.0 (IQR 41-49) and 48.3% experienced an APO. There were significant differences in demographic characteristics by DO quartile (Table 1). Higher proactive coping was associated with decreased odds of adverse perinatal outcomes (OR 0.93, 95% CI 0.89 – 0.99). After adjusting for confounders, each 5-point increase in PCI was associated with a 24% reduction in the odds of having a composite APO (aOR 0.76, 95% CI 0.60 – 0.96). This was predominantly driven by a decrease in cesarean deliveries.

Conclusion:

Higher early pregnancy proactive coping is associated with a significant decrease in APOs, specifically cesarean delivery. Interventions that target improving proactive coping may be a novel mechanism for reducing perinatal morbidity.

Presenting Author(s)

Tess E.K Cersonsky, BS (she/her/hers)
Medical Student
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
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
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

Primary 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