THE BIRTH OUTCOMES AND REPRODUCTIVE NEEDS OF PREMENOPAUSAL BREAST CANCER SURVIVORS: A MIXED METHODS STUDY Public Deposited

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  • March 19, 2019
Creator
  • Black, Kristin
    • Affiliation: Gillings School of Global Public Health, Department of Maternal and Child Health
Abstract
  • This mixed methods dissertation examined the risk of adverse birth outcomes, and the reproductive and sexual health needs of premenopausal breast cancer survivors in North Carolina. Using multivariable binomial regression, the first paper examined the prevalence of preterm birth (PTB) and low birthweight (LBW) according to breast cancer history prior to infant delivery and evaluated potential effect modification by race using statewide linked birth certificate files and Central Cancer Registry data from 1990-2009. A breast cancer history corresponded to 50-67% increases in risk of delivering a PTB or LBW infant compared to the general population, with greater increases among women who received chemotherapy or gave birth within two years of diagnosis. The higher prevalence of PTB and LBW associated with a breast cancer history was greater for white versus black mothers. The second paper explored the reproductive healthcare needs of breast cancer survivors by exploring the concordances and discordances of their reproductive and sexual health needs by post-diagnosis childbearing status and race. Seventeen North Carolinian women with a breast cancer history and diagnosed between the ages of 18-45 participated in a two-part, semi-structured interview. We utilized ResearchTalk’s Sort and Sift, Think and Shift© Method, a multidimensional qualitative analysis approach. This approach, along with member checking the findings with a community advisory committee and participants, allowed us to identify the most salient themes from the data. The five overarching themes were that women with a breast cancer history: 1) received limited reproductive health information; 2) desired realistic expectations of conceiving post-cancer; 3) made lifestyle choices based on family breast cancer history; 4) struggled with adjusting to their altered physical appearance; and 5) had menopause symptoms that led to sexual health and quality of life issues. Despite the many concordances in experiences, there were subtle discordances by post-diagnosis childbearing status and race. Women with a breast cancer history desire more education and resources to address their reproductive and sexual health concerns and would greatly benefit from receiving reproductive and sexual health counseling during breast cancer treatment and beyond.
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  • In Copyright
Advisor
  • Hogan, Vijaya
  • Rowley, Diane
  • Hussey, Jon
  • Eng, Eugenia
  • Nichols, Hazel
Degree
  • Doctor of Philosophy
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2016
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