Pregnancy denial: a complex symptom with life context as a trigger? A prospective case–control study

• Published in: BJOG : an international journal of obstetrics and gynaecology Vol. 129; no. 3; pp. 485 - 492
• Main Authors: Delong, H, Eutrope, J, Thierry, A, Sutter‐Dallay, A‐L, Vulliez, L, Gubler, V, Saad Saint‐Gilles, S, Tessier, E, Le Foll, J, Viaux, S, Apter, G, Danion, A, Auer, J, Rolland, A‐C
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-02-2022; Wiley; John Wiley and Sons Inc
• Subjects: Adult; Age; Case-Control Studies; Contraception; Contraception - psychology; Contraception - statistics & numerical data; Denial, Psychological; education; Educational Status; Female; France; Gynecology and obstetrics; Human health and pathology; Humans; life context; Life Sciences; Logistic Models; marital status; Maternal Age; Mental disorders; newborn; Newborn babies; Odds Ratio; Oral contraceptives; Pregnancy; pregnancy denial; Pregnancy, Unplanned - psychology; Prospective Studies; psychiatric background; Psychiatrics and mental health; Risk Factors; Santé publique et épidémiologie; Statistical analysis; Womens health; Young Adult; France; risk factors; education; life context; pregnancy denial; marital status; newborn; psychiatric background; Age
• ISSN: 1470-0328; 1471-0528
• DOI: 10.1111/1471-0528.16853

Objective
To identify risk factors for a woman to experience pregnancy denial.
Design, setting and population
A French multicentric prospective case–control study with 71 mother–infant dyads having experienced a pregnancy denial versus a control group of 71 dyads.
Methods
Data were collected in the week after delivery using an observational leaflet and two psychiatric scales (MINI and QSSP).
Main outcome measures
Statistically significant differences between the two groups regarding social, demographic, medical and psychiatric data.
Results
Not being in a stable relationship (odds ratio [OR] 17.18, 95% CI 3.37–87.60]; P < 0.0001), not having a high school diploma (OR 1.11, 95% CI 1.04–1.38]; P < 0.0001) and having a psychiatric history (OR 6.33, 95% CI 1.62–24.76; P = 0.0002) were risk factors to experience pregnancy denial, whereas being older was a protective factor (OR 0.86, 95% CI 0.79–0.93; P = 0.0054) (logistic regression, Wald 95% CI). Other risk factors included late declarations of pregnancy history and past pregnancy denials (case n = 7, 9.7% versus 0% in controls; P = 0.01), past pregnancy denials in the family (case n = 13, 18% versus control n = 4, 5.6%; P = 0.03), and use of a contraceptive method (75% for cases versus 7% in control; P < 0.0001), primarily an oral contraceptive (75%).
Conclusion
Family or personal history of pregnancy denial should be part of the systematic anamnesis during the first visit of a patient of child‐bearing age. Further, our study points out that life context (young age, single status, socio‐economic precarity, pill‐based contraception) could be a trigger for pregnancy denial in certain women.
Tweetable
Life context can be a trigger for pregnancy denial.
Tweetable
Life context can be a trigger for pregnancy denial.