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Perceptions of risk in pregnancy with chronic disease: A systematic review and thematic synthesis

Ralston, ER, Smith, P, Chilcot, J, Silverio, SA and Bramham, K (2021) Perceptions of risk in pregnancy with chronic disease: A systematic review and thematic synthesis. PLoS ONE, 16 (7). ISSN 1932-6203

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Open Access URL: https://doi.org/10.1371/journal.pone.0254956 (Published version)


Background Women with chronic disease are at increased risk of adverse pregnancy outcomes. Pregnancies which pose higher risk, often require increased medical supervision and intervention. How women perceive their pregnancy risk and its impact on health behaviour is poorly understood. The aim of this systematic review of qualitative literature is to evaluate risk perceptions of pregnancy in women with chronic disease. Methods Eleven electronic databases including grey literature were systematically searched for qualitative studies published in English which reported on pregnancy, risk perception and chronic disease. Full texts were reviewed by two researchers, independently. Quality was assessed using the Critical Appraisal Skills Programme Qualitative checklist and data were synthesised using a thematic synthesis approach. The analysis used all text under the findings or results section from each included paper as data. The protocol was registered with PROSPERO. Results Eight studies were included in the review. Three themes with sub-themes were constructed from the analysis including: Information Synthesis (Sub-themes: Risk to Self and Risk to Baby), Psychosocial Factors (Sub-themes: Emotional Response, Self-efficacy, Healthcare Relationship), and Impact on Behaviour (Sub-themes: Perceived Risk and Objective Risk). Themes fitted within an overarching concept of Balancing Act. The themes together inter-relate to understand how women with chronic disease perceive their risk in pregnancy. Conclusions Women's pregnancy-related behaviour and engagement with healthcare services appear to be influenced by their perception of pregnancy risk. Women with chronic disease have risk perceptions which are highly individualised. Assessment and communication of women's pregnancy risk should consider their own understanding and perception of risk. Different chronic diseases introduce diverse pregnancy risks and further research is needed to understand women's risk perceptions in specific chronic diseases.

Item Type: Article
Uncontrolled Keywords: Humans; Pregnancy Complications; Chronic Disease; Risk Factors; Health Behavior; Perception; Pregnancy; Adult; Pregnant Women; Female; Data Management; Adult; Chronic Disease; Data Management; Female; Health Behavior; Humans; Perception; Pregnancy; Pregnancy Complications; Pregnant Women; Risk Factors; General Science & Technology
Subjects: B Philosophy. Psychology. Religion > BF Psychology
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Psychology (from Sep 2019)
Publisher: PLos ONE
SWORD Depositor: A Symplectic
Date Deposited: 06 Dec 2022 11:29
Last Modified: 06 Dec 2022 11:29
DOI or ID number: 10.1371/journal.pone.0254956
URI: https://researchonline.ljmu.ac.uk/id/eprint/18295
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