Abstract
The comprehensive assessment of delayed childbearing needs a valid and reliable instrument. Therefore, the aim of the present study was to develop an instrument to evaluate factors influencing delayed childbearing among women and to assess its psychometric properties. The current methodological study was performed in two phases of (i) qualitative instrument development, and (ii) quantitative psychometric assessment of the developed instrument. Face and content validity of the instrument was assessed by eligible women and a panel of experts. Construct validity was assessed using the exploratory factor analysis (EFA). For reliability, internal consistency reliability and intra-rater reliability analysis were used. The initial instrument developed from the qualitative phase consisted of 60 items, which were reduced to 55 items after the face and content validity processes. EFA (n = 300) using the Kaiser criteria (Eigenvalues > 1) and the scree plot led to a six-factor solution accounting for 61.24% of the observed variance. The Cronbach’s alpha coefficient, Spearman’s correlation, test–retest and intra-class correlation coefficients for the whole instrument were reported as 0.83, 0.86 and 0.81, respectively. The final instrument entitled the delayed childbearing questionnaire (DCBQ-55) included 50 items with six domains of ‘readiness for childbearing’, ‘stability in the partner relationship’, ‘awareness about the adverse outcomes of pregnancy in advanced maternal age’, ‘attitude toward delayed childbearing’, ‘family support’, and ‘social support’ on a five-point Likert scale. The DCBQ-55 as a simple, valid and reliable instrument can assess factors influencing delayed childbearing. It can be used by reproductive healthcare providers and policy makers to understand factors influencing delayed childbearing and devise appropriate strategies.
Highlights
Delayed childbearing as ‘a personal choice to postpone childbearing in women over 35 years’has become a health concern in both developed and developing countries [1,2]
Healthcare 2018, 6, 120 the society for childbearing, lack of knowledge of the negative consequences of advanced maternal age, socioeconomic uncertainties and irresponsible partners are some of the known factors underlying delayed childbearing [4,5,6,7]
55 items in six domains of ‘readiness for childbearing’, ‘stability in the partner relationship’, ‘awareness about the adverse outcomes of pregnancy in advanced maternal age’, ‘attitude toward delayed childbearing’, ‘family support’, and ‘social support’, enabling researchers and policymakers to assess the various aspects of this phenomenon overlooked in previous studies
Summary
Delayed childbearing as ‘a personal choice to postpone childbearing in women over 35 years’has become a health concern in both developed and developing countries [1,2]. The postponement of childbearing can lead to a wide range of adverse social, health, and demographic outcomes for the mother and child. It carries the risk of infertility, obstetric complications, pregnancy-associated chronic diseases and neonatal health issues [8,9,10]. Delayed childbearing is a significant risk factor for low birth weight, but some positive associations have been reported between the maternal profile and birth outcomes among women aged ≥ 35 years [11]. It is recommended to create a balance between inter-pregnancy intervals associated with higher risks for adverse pregnancy outcomes and increased maternal age at delivery [12]. In terms of psychological issues, those women who are childless after delaying childbearing experience similar feelings to those women that are childless after infertility [13]
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