Probability of parenthood after early onset cancer: a population-based study

We evaluated in a population-based setting the postdiagnosis parenthood among survivors compared with the fertility patterns of siblings. Cancer patients aged 0-34 years at diagnosis were identified from the Finnish Cancer Registry (N = 25,784), and their siblings (N = 44,611) by registry linkage. Further linkage identified the offspring of the patient and sibling cohorts. The relative probabilities of parenthood for first and second births separately were estimated for male and female survivors in different diagnostic age-groups and subsites using a Cox proportional hazards model, with age as the time variable and adjusting for the birth cohort of parents. In addition, estimates were calculated for 5 diagnostic eras in all subsites combined. Compared to siblings, both female and male cancer survivors were less likely to parent at least 1 child (RR 0.46, 95% CI 0.44-0.48 and RR 0.57, 95% CI 0.54-0.60, respectively). The relative probability of parenthood was especially low in male childhood cancer survivors and female young adult cancer survivors. However, cancer patients were only slightly less likely than siblings to parent a second child, with RR 0.91, 95% CI 0.86-0.97 and RR 0.95, 95% CI 0.89-1.01 for females and males, respectively. The relative probability of parenthood increased over calendar time among young adult cancer patients. The relative probability of parenthood following early onset cancer was overall significantly reduced by approximately 50%. Parenting a second child, however, was not reduced among pediatric and adolescent survivors, and only slightly reduced among early adulthood cancer survivors compared to siblings.     

Psychosocial adjustment during the transition to parenthood of Portuguese couples who conceived spontaneously or through assisted reproductive technologies

We examined the psychosocial adjustment of 35 Portuguese couples who conceived through Assisted Reproductive Technologies (ART) and 31 couples with a spontaneous conception during their transition to parenthood (pregnancy and 4 months postpartum). Couples completed self‐report questionnaires regarding their perceptions of pregnancy and parenthood, psychological distress, quality of life, marital relationship, and parenting stress. Compared with parents who conceived spontaneously, parents who conceived through ART perceived pregnancy as being more risky and demanding, reported a decrease in their psychological quality of life, and ART fathers only perceived themselves as being more competent than fathers who conceived spontaneously. Healthcare professionals should be aware of need of couples in their efforts to adapt to the individual and relational challenges associated with the transition to parenthood. © 2010 Wiley Periodicals, Inc. Res Nurs Health 33:207–220, 2010     

Adolescent mothers' perspectives regarding their own psychosocial and health needs: a qualitative exploratory study in Belgium

Objectives

We looked at early pregnancy and parenthood as an opportunity to broaden our understanding of the reproductive health education needs met by adolescent girls.

Methods

We conducted an in-depth interview study with 12 adolescent mothers.

Results

To become a mother at a young age was perceived as meaningful to all the participants. The participants expressed a need to be addressed as adult parents, who want the best for their child. A variety of psychosocial and health needs emerged over a time span ranging from starting to be sexually active to after the child was born. Social isolation was found to be an important factor of vulnerability.

Conclusion

The health needs of adolescent mothers extend well beyond counselling around the decision to continue or terminate pregnancy, and subsequent information on contraception methods to avoid further pregnancies. Adolescent mothers need to be supported in their transition to parenthood, and special care should be provided to girls who are socially isolated.

Practice implications

We identified several avenues for health education and counselling to adolescent mothers, from primary prevention to reduce incidence of early pregnancies to tertiary prevention to reduce negative health outcomes for both mother and child.     

Ukrainian medical students’ attitudes to parenthood and knowledge of fertility

Objectives: The aim of our study was to investigate Ukrainian medical students’ intentions and attitudes in relation to future parenthood, and their knowledge about fertility. Methods: A classroom survey was carried out of randomly selected groups among 3568 Russian-speaking medical students. The response rate was 88.8%; 858 were female and 407 were male; the mean age was 20.6 (standard deviation [SD] 2.4) years. Results: One in four male and 16% of female respondents did not want to have children, 3.3% had children and 17% wanted one child only. Female respondents wished to have their first child when they were 24.4 (SD 2.4) years of age, and male respondents when they were 26.8 (SD 3.4) years of age. Around 60% of respondents reported there was a pronounced decline in female fertility after the age of 45 years. Conclusions: The desire to have children in the future is not apparent among medical students, especially not among men. Gaps in students’ knowledge about fertility need to be addressed by sexual and reproductive education.     

Parenthood probability and pregnancy outcome in patients with a cancer diagnosis during adolescence and young adulthood

BACKGROUND: To compare first-time parenthood probability and pregnancy outcome between cancer patients and the general population. METHODS: Data from a hospital registry on cancer patients aged 15-35 years at diagnosis, including date/type of diagnosis, treatment and date of death, were merged with data from the Cancer Registry and the Medical Birth Registry, providing date of childbirth, IVF, pregnancy outcomes and demographics. RESULTS: The first-time parenthood probability at the age of 35 years was 63% in male patients (n = 463) and 64% in the male general population (n = 367 068). Figures in female patients were 66% (n = 284) compared with 79% in the female general population (n = 349 576) (P = 0.007). A total of 487 male and 251 female cancer patients were childless pre-diagnosis, and 130 male and 104 female cancer patients had one child before diagnosis and at least one birth post-diagnosis. Congenital anomalies were more frequent in first-borns to previously childless male patients [adjusted odds ratio (OR(adj)): 1.5; 95% confidence interval (CI): 1.1-2.3]. The risk of low birth weight and preterm delivery after cancer was increased in infants born to female patients, as was perinatal mortality (OR(adj) 2.3; 95% CI: 1.1-5.0) among post-diagnosis first births. CONCLUSIONS: The first-time parenthood probability in 35-year old cancer patients is approximately 60%, which in female patients is significantly reduced compared with the general population. Post-diagnosis pregnancies to female patients are high-risk pregnancies.     

Psycho-education to enhance couples' transition to parenthood

A substantial proportion of couples struggle to adapt to parenthood, feel stress in caring for their infant, and experience a significant decline in their couple relationship adjustment. Moreover, there is a substantial association between effective parenting of infants and sustaining a mutually satisfying couple relationship. This paper reviews randomized controlled trials of psycho-education to assist new parent couples with parenting and their couple relationship. The majority of programs target either the couple relationship or parenting, with few programs addressing both areas. The best outcomes seem to be achieved when programs are accessible by couples at home, when skill-training is provided, and possibly when programs target couples at high-risk of maladjustment to parenthood.     

Swedish Parents’ Experiences of Parenthood and the Need for Support to Siblings When a Baby is Stillborn

Abstract: Background: It has been argued that having a stillborn baby in the family affects older siblings more than parents realize. The aim of this study was to describe parenthood and the needs of siblings after stillbirth from the parents’ perspective. Methods: Six focus groups were held with 27 parents who had experienced a stillbirth and who had had children before the loss. The discussion concerned parents’ support to the siblings, and the sibling’s meeting, farewell, and memories of their little sister or brother. Data were analyzed using qualitative content analysis. Results: The overall theme of the findings was parenthood in a balance between grief and everyday life. In the analysis, three categories emerged that described the construction of the theme: support in an acute situation, sharing the experiences within the family, and adjusting to the situation. Conclusions: The siblings’ situation is characterized by having a parent who tries to maintain a balance between grief and everyday life. Parents are present and engaged in joint activities around the stillbirth together with the siblings of the stillborn baby. Although parents are aware of the sibling’s situation, they feel that they are left somewhat alone in their parenthood after stillbirth and therefore need support and guidance from others. (BIRTH 38:2 June 2011)