Psychometric evaluation of the perception of future pregnancy risk questionnaire (PFPRQ) in women with cardiometabolic risk factors

OBJECTIVES: To develop the Perception of Future Pregnancy Risk Questionnaire (PFPRQ) to assess perceived risk related to future pregnancies by adapting the existing Perception of Pregnancy Risk Questionnaire. The PFPRQ was psychometrically evaluated among parous, reproductive-age women with cardiometabolic disease risk factors. STUDY DESIGN: A cross-sectional study. MAIN OUTCOME MEASURES: The PFPRQ was evaluated for construct validity using exploratory factor analysis. Criterion-related validity was assessed through correlations with the Generalized Anxiety Disorder-7 (GAD-7) scale, the American Diabetes Association Diabetes Risk Test, and demographic variables. Reliability was examined using Cronbach's alpha. RESULTS: The PFPRQ, consisting of 7 items rated on a visual analog scale from 0 (no risk at all) to 100 (extremely high risk), was administered to 243 participants and demonstrated a single-factor structure (Risks for Mother and Baby in Future Pregnancy) with high internal consistency reliability (Cronbach's alpha = 0.89). Higher scores on the PFPRQ indicate higher perception of risk. Criterion-related validity showed a weak positive correlation between anxiety and PFPRQ scores (Spearman's rho = 0.173, p = 0.007). Higher PFPRQ scores were also associated with diagnosis of high blood pressure (p < 0.001), intention for future pregnancy (p < 0.001), and willingness to delay pregnancy for health reasons (p = 0.02), supporting its criterion-related validity of the PFPRQ. DISCUSSION: The PFPRQ demonstrated good internal consistency and showed evidence of construct and criterion-related validity for assessing perceived future pregnancy risk among reproductive-age women with cardiometabolic factors. It provides valuable insights to support risk communication and preconception counseling.