Abstract
BackgroundAdvanced maternal age (AMA) is associated with several adverse pregnancy outcomes, hence these pregnancies are considered to be “high risk.” A review of the empirical literature suggests that it is not clear how women of AMA evaluate their pregnancy risk. This study aimed to address this gap by exploring the risk perception of pregnant women of AMA.MethodsA qualitative descriptive study was undertaken to obtain a rich and detailed source of explanatory data regarding perceived pregnancy risk of 15 women of AMA. The sample was recruited from a variety of settings in Winnipeg, Canada. In-depth interviews were conducted with nulliparous women aged 35 years or older, in their third trimester, and with singleton pregnancies. Interviews were recorded and transcribed verbatim, and content analysis was used to identify themes and categories.ResultsFour main themes emerged: definition of pregnancy risk, factors influencing risk perception, risk alleviation strategies, and risk communication with health professionals.ConclusionsSeveral factors may influence women's perception of pregnancy risk including medical risk, psychological elements, characteristics of the risk, stage of pregnancy, and health care provider’s opinion. Understanding these influential factors may help health professionals who care for pregnant women of AMA to gain insight into their perspectives on pregnancy risk and improve the effectiveness of risk communication strategies with this group.
Highlights
Advanced maternal age (AMA) is associated with several adverse pregnancy outcomes, these pregnancies are considered to be “high risk.” A review of the empirical literature suggests that it is not clear how women of AMA evaluate their pregnancy risk
Current knowledge of risk perception at AMA is based on a few studies that most of them primarily focused on pregnancy experiences, in which risk perception was discussed as part of the pregnancy and birth experience
In 2007, Carolan and Nelson conducted a secondary analysis of the qualitative data and identified four themes central to perception of pregnancy risk including "realizing I was at risk," "hoping for reassurance," "dealing with uncertainty," and "getting through it/negotiating risk"[14], p
Summary
Advanced maternal age (AMA) is associated with several adverse pregnancy outcomes, these pregnancies are considered to be “high risk.” A review of the empirical literature suggests that it is not clear how women of AMA evaluate their pregnancy risk. Windridge and Berryman (1999), in a study of 107 British women’s experiences of giving birth at AMA, explored risk perception and reported that women of AMA may perceive a higher risk for their babies during labor because of their older age [15]. Another notable study on this topic is an Australian qualitative study of 22 prim gravid women of AMA that was initially conducted to understand the experiences of women of AMA [16]. This study had a number of limitations such as retrospective data collection (36 months after delivery) and its unique population (participants who chose midwifery care), which should be considered in the interpretation of the results
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