Comparison of Health Practices and Depression in Planned and Unplanned Pregnancies

Öz

Aim: The aim of this study was to compare health practices and depression in planned and unplanned pregnancies. Subjects and Methods: The study was designed as a descriptive cross-sectional study. The research sample consists of a total of 230 pregnant women with planned and unplanned pregnancy. The population of this descriptive study consists of pregnant women attending the obstetrics clinics of a public hospital. The sample consisted of 230 pregnant women calculated with the g-power program (115 planned pregnancies and 115 correspondingly selected unplanned pregnancies). The data were collected using the Descriptive Information Form, the Health Practices in Pregnancy Questionnaire, and the Beck Depression Inventory. Results: The mean age of the pregnant women was 29.06±5.71 (min: 18, max: 42). The Health Practices in Pregnancy Questionnaire scores of pregnant women were 127.10±12.03 for planned pregnancies and 124.06±12.00 for unplanned pregnancies. Women with planned pregnancies received 9.97±8.56 from the Beck Depression Inventory, and those with unplanned pregnancies received 10.83±7.75. No significant difference was found between the mean scores of the Health Practices in Pregnancy Questionnaire (p=0.058) and the Beck Depression Inventory (p=0.425) depending on the pregnancy planning status. When planned and unplanned pregnancies are evaluated separately, there is a negative correlation between Beck Depression Inventory and Health Practices in Pregnancy Questionnaire scores (p=0.006, r=0.179). As the Beck Depression Inventory score increases, the total scores of the Health Practices in Pregnancy Questionnaire decrease. Conclusion: Women with planned pregnancy had higher total scores on the scale of health practices during pregnancy than women with unplanned pregnancy. When planned and unplanned pregnancies were evaluated separately, there was a negative relationship between Beck Depression Inventory and Health Practices in Pregnancy Questionnaire scores. In maintaining maternal and fetal health; it is important to determine the health practices and depression status of women during pregnancy starting from the preconceptional period, to plan pregnancies, and to question negative health behaviors.

Anahtar Kelimeler

• Depression
• health practices during pregnancy
• unplanned pregnancies

Planlı ve Plansız Gebeliklerde Sağlık Uygulamaları ve Depresyonun Karşılaştırılması

Öz

Amaç: Bu çalışmanın amacı, planlı ve plansız gebeliklerde sağlık uygulamaları ve depresyonu karşılaştırmaktır. Örneklem ve Yöntem: Çalışma tanımlayıcı kesitsel bir çalışmadır. Araştırmanın örneklemini, planlı ve plansız gebeliği olan toplam 230 gebe oluşturmaktadır. Bu tanımlayıcı kesitsel çalışmanın evrenini, bir devlet hastanesinin kadın doğum polikliniklerine başvuran gebeler oluşturmaktadır. Örneklem, G-power programı kullanılarak hesaplanan 230 gebeden (115 planlı gebelik, 115 plansız gebelik) oluşmuştur. Veriler, Tanımlayıcı Bilgi Formu, Gebelikte Sağlık Uygulamaları Ölçeği ve Beck Depresyon Envanteri kullanılarak toplanmıştır. Bulgular: Gebelerin yaş ortalaması 29.06±5.71 (min: 18, max: 42) olarak bulunmuştur. Planlı gebeliklerde GSUÖ puanları 127.10±12.03, plansız gebeliklerde ise 124.06±12.00 olarak belirlenmiştir. Planlı gebeliklerdeki kadınların Beck Depresyon Skalası puanı 9.97±8.56, plansız gebeliklerdeki kadınların ise 10.83±7.75 olarak bulunmuştur. Gebelik planlama durumuna göre Gebelikte Sağlık Uygulamaları Ölçeği (p=0.058) ve Beck Depresyon Envanteri (p=0.425) puanları arasında anlamlı bir fark bulunmamıştır. Beck Depresyon Envanteri ile Gebelikte Sağlık Uygulamaları Ölçeği puanları arasında negatif yönlü bir ilişki vardır (p=0.006, r=0.179). Beck Depresyon Envanteri puanları arttıkça Gebelikte Sağlık Uygulamaları Ölçeği toplam puanları azalmaktadır. Sonuç: Gebeliği planlı olan kadınların gebelikte sağlık uygulamaları ölçek toplam puanları gebeliği plansız olan gebelere göre daha yüksektir. Planlı ve plansız gebelikler ayrı ayrı değerlendirildiğinde, Beck Depresyon Envanteri ve Gebelikte Sağlık Uygulamaları Ölçeği puanları arasında negatif bir ilişki bulunmuştur. Anne ve bebek sağlığının korunmasında; gebelik öncesi dönemde kadınların sağlık uygulamaları ve depresyon durumlarının belirlenmesi, gebeliklerin planlanması ve olumsuz sağlık davranışlarının sorgulanması önemli bir faktördür.

Anahtar Kelimeler

• Depresyon
• gebelikte sağlık uygulamaları
• planlı gebelikler
• plansız gebelikler

Kaynakça

1. Alhusen, J.L., & Alvarez, C. (2016). Perinatal depression. The Nurse Practitioner, 41(5), 50-55. https://doi.org/10.1097/01.NPR.0000480589.09290.3e
2. Aggarwal, R., & Ranganathan, P. (2019). Study designs: Part 2–descriptive studies. Perspectives in clinical research, 10(1), 34. https://doi.org/10.4103/picr.PICR_154_18
3. Biaggi, A., Conroy, S., Pawlby, S., & Pariante, C.M. (2016). Identifying the women at risk of antenatal anxiety and depression: a systematic review. Journal of affective disorders, 191:62–77. https://doi.org/10.1016/j.jad.2015.11.014
4. Boekhorst, M. G., Beerthuizen, A., Endendijk, J. J., Van Broekhoven, J. E., Van Baar, A., Bergink, V., & Pop, V. J. (2019). Different trajectories of depressive symptoms during pregnancy. Journal of affective disorders, 248, 139-146. https://doi.org/10.1016/j.jad.2019.01.021
5. Borges, A. L. V., Barrett, G., Dos Santos, O. A., Nascimento, N. D. C., Cavalhieri, F. B., & Fujimori, E. (2016). Evaluation of the psychometric properties of the London Measure of nplanned Pregnancy in Brazilian Portuguese. BMC Pregnancy and Childbirth, 16(1), 1-8. https://doi.org/10.1186/s12884-016-1037-2
6. Carlander, A., Hultstrand, J. N., Reuterwall, I., Jonsson, M., Tydén, T., & Kullinger, M. (2023). Unplanned pregnancy and the association with maternal health and pregnancy outcomes: A Swedish cohort study. Plos one, 18(5), e0286052. https://doi.org/10.1371/journal.pone.0286052
7. Çelik, A.S., & Derya, Y.A., (2019). Determining the Self-Care Agency and the Health Practice Levels of the Pregnant Women and the Effective Factors. Gümüşhane University Journal of Health Sciences, 8(1), 111-119. https://dergipark.org.tr/tr/download/article-file/682093
8. Du Toit, E., Jordaan, E., Niehaus, D., Koen, L., & Leppanen, J. (2018). Risk factors for unplanned pregnancy in women with mental illness living in a developing country. Archives of Women's Mental Health, 21, 323-331. https://doi.org/10.1007/s00737-017-0797-7

9. Enthoven, C. A., El Marroun, H., Koopman-Verhoeff, M. E., Jansen, W., Lambregtse-van den Berg, M. P., Sondeijker, F., & Jansen, P. W. (2022). Clustering of characteristics associated with unplanned pregnancies: the generation R study. BMC Public Health, 22(1), 1957. https://doi.org/10.1186/s12889-022-14342-y
10. Er, S. (2006). Validity and Reliability Study of Turkish Form of Pregnancy Health Practices Scale, Ege University Institute of Health Sciences, Women's Health and Diseases Nursing, (Unpublished Master's Thesis, İzmir).
11. Faisal-Cury, A., Menezes, P. R., Quayle, J., & Matijasevich, A. (2017). Unplanned pregnancy and risk of maternal depression: secondary data analysis from a prospective pregnancy cohort. Psychology, health & medicine, 22(1), 65-74. https://doi.org/10.1080/13548506.2016.1153678
12. Gomez, A. M., Arteaga, S., Ingraham, N., Arcara, J., & Villaseñor, E. (2018). It's not planned, but is it okay? The acceptability of unplanned pregnancy among young people. Women's Health Issues, 28(5), 408-414. https://doi.org/10.1016/j.whi.2018.07.001
13. Goossens, J., Van Den Branden, Y., Van der Sluys, L., Delbaere, I., Van Hecke, A., Verhaeghe, S., & Beeckman, D. (2016). The prevalence of unplanned pregnancy ending in birth, associated factors, and health outcomes. Human Reproduction, 31(12), 2821-2833. https://doi.org/10.1093/humrep/dew266
14. Hisli, N. (1988). A study on the validity of Beck Depression Inventory. Journal of Psychology, 6, 118-122.
15. Hisli, N. (1989). A reliability and validity study of Beck Depression Inventory in a university student sample. Journal of Psychology., 7, 3-13.
16. Lindgren, K. (2001). Relationships among maternal–fetal attachment, prenatal depression, and health practices in pregnancy. Research in nursing & health, 24(3), 203-217. https://doi.org/10.1002/nur.1023
17. Lindgren, K. (2005). Testing the health practices in pregnancy questionnaire–II. Journal of Obstetric, Gynecologic, & Neonatal Nursing, 34(4), 465-472. https://doi.org/10.1177/0884217505276308
18. McDougall, B., Kavanagh, K., Stephenson, J., Poston, L., Flynn, A. C., & White, S. L. (2021). Health behaviours in 131,182 UK women planning pregnancy. BMC Pregnancy and Childbirth, 21(1), 530. https://doi.org/10.1186/s12884-021-04007-w
19. Muskens, L., Boekhorst, M. G., Kop, W. J., van den Heuvel, M. I., Pop, V. J., & Beerthuizen, A. (2022). The association of unplanned pregnancy with perinatal depression: a longitudinal cohort study. Archives of Women's Mental Health, 25(3), 611-620. https://doi.org/10.1007/s00737-022-01225-9.
20. Nazik, F., & Oğuzöncül, A.F. (2017). Depression and influencing factor in pregnancy: A community-based study. International Journal of Medical Science and Public Health, 6(11),1635-1639. https://doi.org/10.5455/ijmsph.2017.0822725092017
21. Nelson, H. D., Darney, B. G., Ahrens, K., Burgess, A., Jungbauer, R. M., Cantor, A., & Fu, R. (2022). Associations of unintended pregnancy with maternal and infant health outcomes: a systematic review and meta-analysis. JAMA, 328(17), 1714-1729. https://doi.org/10.1001/jama.2022.19097
22. The American College of Obstetricians and Gynecologists (ACOG). (2019). Prepregnancy counseling. Obstetrics Gynecology, 133(1), e78–89. https://doi.org/10.1097/AOG.0000000000003013
23. Weller, B. K., & Sirin, A. S. (2017). Evaluation of health-related behaviors and attitudes of women during pregnancy in Edirne, Turkey. Studies on Ethno-Medicine, 11(1), 55-62. https://doi.org/10.31901/24566772.2017/11.01.09
24. Yanikkerem, E., Ay, S., Mutlu, S., & Goker, A. (2013a). Antenatal depression: prevalence and risk factors in a hospital based Turkish sample. The Journal of the Pakistan Medical Association, 63(4), 472-7. https://pubmed.ncbi.nlm.nih.gov/23905444/
25. Yanikkerem, E., Ay, S., & Piro, N. (2013b). Planned and unplanned pregnancy: effects on health practice and depression during pregnancy. Journal of Obstetrics and Gynaecology Research, 39(1), 180-187. https://doi.org/10.1111/j.1447-0756.2012.01958.x