Perinatal factors related to pregnancy and childbirth satisfaction: a prospective cohort study

Figures & data

Figure 1. Flowchart sub cohort Expect Study I.

Table 1. Characteristics of the non-responders, the observed cohort, imputed cohort, and women lost to follow-up.

Characteristics	Non-response (n = 651)	Observed cohort complete cases (n = 702)	Missing values, n (%)	Imputed cohort (n = 739)	Lost to follow-up (n = 146)
Maternal characteristics
Age, years	30.3 (3.9)	30.7 (3.7)	0 (0.0)	30.7 (3.6)	29.9 (3.9)
Tertiary level of education, n (%)	355 (54.5)	454 (64.7)	0 (0.0)	478 (64.7)	68 (46.6)
Socio-economic status score	−0.64 (1.2)*	−0.5 (1.1)	12 (1.6)	−0.5 (1.1)	−0.8 (1.1)
Body mass index, kg/m^2	24.2 (4.1)	24.0 (4.2)	0 (0.0)	24.0 (4.2)	24.7 (4.3)
Nulliparous, n (%)	295 (45.3)	360 (51.4)	0 (0.0)	383 (51.8)	65 (44.5)
State anxiety score	–	33.4 (8.7)	2 (0.3)	33.4 (8.7)	34.1 (7.6)
Antepartum anxiety, n (%)	–	173 (24.7)	2 (0.3)	184 (24.9)	32 (21.9)
Neonatal outcomes
Neonatal composite outcome, n (%)	28 (4.3)	31 (4.4)	0 (0.0)	33 (4.5)	9 (6.2)
Birthweight <2.3 percentile	7 (1.1)	8 (1.1)	0 (0.0)	8 (1.1)	1 (0.7)
Preterm birth <32 weeks of gestation, n (%)	13 (2.0)	4 (0.6)	0 (0.0)	5 (0.7)	2 (1.4)
APGAR score < 7, n (%)	10 (1.5)*	10 (1.4)	0 (0.0)	11 (1.5)	4 (2.7)
NICU admission within 28 days of birth, n (%)	16 (2.5)	15 (2.1)	0 (0.0)	16 (2.2)	5 (3.4)
Perinatal death, n (%)	7 (1.1)	2 (0.3)	0 (0.0)	2 (0.3)	1 (0.7)
Maternal outcomes
Decrease in perceived personal wellbeing, n (%)	–	182 (26.0)	13 (1.78)	186 (26.0)	–
Maternal composite outcome, n (%)	–	83 (11.9)	10 (1.4)	89 (12)	–
Pre-eclampsia, n (%)	12 (1.8)	19 (2.7)	0 (0.0)	21 (2.8)	4 (2.7)
Gestational diabetes, n (%)	10 (1.5)	20 (2.9)	0 (0.0)	22 (3)	8 (5.5)
Postpartum hemorrhage, n (%)	27 (4.1)*	46 (6.6)	0 (0.0)	49 (6.6)	6 (4.1)
Intensive or High Care admission, n (%)	–	6 (0.9)	13 (1.8)	7 (0.9)	0 (0.0)
Obstetric care services					–
Antepartum care led by midwife, n (%)	–	451 (64.2)	0 (0.0)	476 (64.4)	91 (62.3)
Antepartum care led by obstetrician, n (%)	–	137 (19.5)	0 (0.0)	145 (19.6)	35 (24.0)
Transfer during antepartum care, n (%)	–	114 (16.2)	0 (0.0)	118 (16.0)	20 (13.7)
Labor led by midwife, n (%)	189 (29.0)	233 (33.2)	0 (0.0)	239 (32.3)	38 (26.0)
Labor led by obstetrician, n (%)	335 (51.5)	369 (52.6)	0 (0.0)	394 (53.3)	81 (55.5)
Transfer during labor, n (%)	127 (19.5)	100 (14.2)	0 (0.0)	106 (14.3)	27 (18.5)
Spontaneous vaginal birth, n (%)	480 (73.7)*	525 (75.0)	0 (0.0)	555 (75.1)	99 (67.8)
Instrumental vaginal birth, n (%)	63 (9.7)*	58 (16.7)	0 (0.0)	63 (8.5)	18 (12.3)
Cesarean section, n (%)	104 (16.0)*	117 (14.3)	0 (0.0)	121 (16.4)	29 (19.9)
Analgesics during labor, n (%)	303 (46.5)*	304 (43.3)	4 (0.5)	326 (44.1)	88 (60.3)

Data expressed as mean (standard deviation), or n (%).

Variables with a minus (−) sign could not be retrieved without the additional surveys.

*These variables had some missing data among women who did not complete any of the additional surveys; socio-economic state score (n = 13); APGAR score (n = 6); postpartum hemorrhage (n = 3); mode of giving birth (n = 4); analgesics during labor (n = 21).

Table 2. Pregnancy and Childbirth Questionnaire scores.

Scale	All respondents (n = 739)	Satisfied respondents (n = 563)	Dissatisfied respondents (n = 176)
Total score (25 items)	109.7 (12.5)	115 (8.3)	92.6 (6.8)
Personal treatment during pregnancy (11 items)	49.1 (5.8)	51 (3.9)	41.7 (4.1)
Education information (7 items)	30.3 (4.2)	32 (3.2)	25.3 (3.1)
Personal treatment during labor (7 items)	30.3 (4.5)	32 (3.6)	25.6 (3.9)

Data expressed as mean (standard deviation).

Table 3. Multiple logistic regression of maternal and healthcare factors related to pregnancy and childbirth discontent.

	Satisfied (n = 563) Mean (SD) or n (%)	Dissatisfied (n = 176) Mean (SD) or n (%)	Unadjusted odds ratio (95% CI)	Adjusted odds ratio (95% CI)
Patient related factors
Age (continuous)	30.8 (3.7)	30.4 (3.7)	0.97 (0.93–1.02)	0.95 (0.90–1.00)
Socio-economic status (continuous)	−0.5 (1.1)	−0.5 (1.0)	1.02 (0.87–1.19)	1.08 (0.91–1.29)
Primary or secondary level of education	197 (35.0)	64 (36.4)	1 [Reference]	1 [Reference]
Tertiary level of education	366 (65.0)	112 (63.6)	0.94 (0.66-1.34)	1.05 (0.71-1.55)
Multiparous	271 (48.1)	85 (48.3)	1 [Reference]	1 [Reference]
Nulliparous	292 (51.9)	91 (51.7)	0.99 (0.71–1.40)	0.98 (0.65–1.48)
No neonatal composite outcome	537 (95.4)	112 (63.6)	1 [Reference]	1 [Reference]
Neonatal composite outcome	26 (4.6)	7 (4.0)	0.86 (0.34–1.90)	0.58 (0.22–1.36)
No maternal composite outcome	557 (98.9)	152 (86.4)	1 [Reference]	1 [Reference]
Maternal composite outcome	6 (1.07)	24 (13.6)	1.21 (0.72–1.97)	0.98 (0.56–1.67)
No decreased perceived personal wellbeing	435 (77.3)	118 (67.0)	1 [Reference]	1 [Reference]
Decreased perceived personal wellbeing	128 (22.7)	58 (33.0)	1.70 (1.17–2.45)*	1.62 (1.09–2.40)*
No antenatal anxiety	444 (78.9)	139 (79.0)	1 [Reference]	1 [Reference]
Antenatal anxiety	119 (21.0)	37 (21.0)	2.18 (1.51–3.15)*	2.23 (1.50–3.30)*
Obstetric care related factors
Healthcare professional care during antenatal care
Antenatal care led by midwife	387 (68.7)	89 (50.6)	1 [Reference]	1 [Reference]
Antenatal care led by obstetrician	103 (18.3)	42 (23.9)	1.77 (1.15–2.71)	1.12 (0.67–1.85)
Transfer during antenatal care	73 (13.0)	45 (25.6)	2.68 (1.73–4.14)*	1.82 (1.10–3.00)*
Healthcare professional during labor
Labor led by midwife	202 (35.9)	37 (21.0)	1 [Reference]	1 [Reference]
Labor led by obstetrician	269 (47.8)	125 (71.0)	2.54 (1.70–3.86)*	2.33 (1.34–4.08)*
Transfer during labor	92 (16.3)	14 (8.0)	0.83 (0.42–1.58)	0.80 (0.37–1.65)
No analgesics used during labor	324 (57.5)	89 (50.6)	1 [Reference]	1 [Reference]
Analgesics used during labor	239 (42.5)	87 (49.4)	1.33 (0.94–1.86)	0.71 (0.43–1.16)
Mode of giving birth
Spontaneous vaginal labor	436 (77.4)	119 (67.6)	1 [Reference]	1 [Reference]
Instrumental vaginal labor	47 (8.3)	16 (9.1)	1.25 (0.66–2.23)	1.19 (0.60–2.30)
Cesarean section	80 (14.2)	41 (23.3)	1.88 (1.22–2.87)*	1.53 (0.88–2.63)

*p < .05.