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alspac_91_hab
HAVING A BABY
This questionnaire asks about how you have been feeling so far in your pregnancy.
Your answers are confidential. Your name will not be on the questionnaire and none of the doctors or nurses you see will know your answers.
Please answer all the questions you can. If there are any you cannot answer or do not wish to answer that is fine. Just leave them blank.
THANK YOU VERY MUCH FOR YOUR HELP
SECTION A: YOUR PREVIOUS PREGNANCIES
A1

Have you ever been pregnant before?

1
Yes
2
No
If no, go to Section B, on page 6.
If yes,
qc_A1 == 1
A2 a

How many times have you been pregnant altogether before this time?

How many
A2 b

Is this the first pregnancy with your present partner?

1
Yes
2
No
9
Am not sure
A3 a

How many children still living, of your own do you have?

How many
A3 b

Do they all live with you?

1
Yes
2
No
7
Don't have children
A4 a

Have you ever had any miscarriages?

1
Yes
2
No
If yes,
qc_A4_a == 1
A4 b

how many times have you miscarried?

How many
A5 a

Have you ever had any abortions or terminations?

1
Yes
2
No
If yes,
qc_A5_a == 1
A5 b

how many ?

How many
A6 a

Have you ever had a stillborn baby ?

1
Yes
2
No
If yes,
qc_A6_a == 1
A6 b

how many?

How many
A7 a

Have you ever had any babies who were born alive but died later?

1
Yes
2
No
If yes, please describe:
qc_A7_a == 1
A7 b

how many?

How many
A7 c

what caused their death?

Generic text
A7 d

how old were they when they died?

Generic text
A8

Were any of your babies under 5lb 8oz (2500 grammes) at birth?

1
Yes
2
No
9
Don't know
A9 a

Were any of your babies born more than 3 weeks early?

1
Yes
2
No
9
Don't know
A9 b

Have you ever had a caesarean section?

1
Yes
2
No
9
Don't know
A10

How old were you when you became pregnant for the very first time? ... years

Age
A11 a

What was the outcome of the last pregnancy before this pregnancy?

1
miscarriage
2
abortion or termination
3
stillbirth
4
liveborn baby that died
5
liveborn baby still alive
6
other (please describe)
Other
A11 b

Please give the date of your last birth/miscarriage/abortion or termination before this pregnancy:

Generic date
A11 c

Did you breast feed your last baby?

1
Yes
2
No
7
Have not had a baby
If yes,
qc_A11_c == 1
A11 d

for how long?

1
under 1 month
2
1-3 months
3
more than 3 months
SECTION B: YOUR HEALTH
B1 a

How would you describe your health: up to the time of your present pregnancy

1
Always fit & well
2
Usually fit & well
3
Sometimes unwell
4
Often unwell
5
Always unwell
B1 b

How would you describe your health: in the first months of this pregnancy

1
Always fit & well
2
Usually fit & well
3
Sometimes unwell
4
Often unwell
5
Always unwell
B1 c

How would you describe your health: in the last two weeks

1
Always fit & well
2
Usually fit & well
3
Sometimes unwell
4
Often unwell
5
Always unwell
B2 a

During this pregnancy so far have you had any of the following: nausea

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 b

During this pregnancy so far have you had any of the following: vomiting

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 c

During this pregnancy so far have you had any of the following: diarrhoea

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 d

During this pregnancy so far have you had any of the following: vaginal bleeding

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 e

During this pregnancy so far have you had any of the following: jaundice

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 f

During this pregnancy so far have you had any of the following: urinary infection

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 g

During this pregnancy so far have you had any of the following: influenza

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 h

During this pregnancy so far have you had any of the following: rubella (german measles)

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 j

During this pregnancy so far have you had any of the following: thrush (candida)

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 k

During this pregnancy so far have you had any of the following: genital herpes

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 l

During this pregnancy so far have you had any of the following: other infection (please describe)

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
Other
B2 m

During this pregnancy: injury or shock to you (please describe)

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
Generic text
B2 n

During this pregnancy: sugar in urine

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 o

During this pregnancy: x-ray

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 p

During this pregnancy: amniocentesis

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 q

During this pregnancy: chorionic villus sampling (CVS)

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 r

During this pregnancy: AFP test (spina bifida test)

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 s

During this pregnancy: ultrasound scan

1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B3 a

Have you been admitted to hospital during this pregnancy?

1
Yes
2
No
If no, go to B4, on page 8.
If yes,
qc_B3_a == 1
B3 b
give reason for each admission:
Reason Date admitted Number of days stayed
Generic textHow manyGeneric dateGeneric textHow manyGeneric dateHow manyGeneric dateGeneric text Generic textHow manyGeneric dateGeneric textHow manyGeneric dateHow manyGeneric dateGeneric text Generic textHow manyGeneric dateGeneric textHow manyGeneric dateHow manyGeneric dateGeneric text
1
2
3
4
5
B4 a-o
During this pregnancy have you ever taken any medicines, pills or used ointment or suppositories for the following:
-

1 - Yes, taken in 1st 3 months of pregnancy

2 - Yes, taken later in pregnancy

4 - No, not at all
nausea
heartburn
vomiting
anxiety
infection
migraine
difficulty going to sleep
pain
allergies
skin condition
bleeding
depression
piles
constipation
cough
B4 p

During this pregnancy have you ever taken any medicines, pills or used ointment or suppositories for the following: Medicines, pills or ointments for: other reason (please describe)

1
Yes, taken in 1st 3 months of pregnancy
2
Yes, taken later in pregnancy
4
No, not at all
Other
B5 a

During this pregnancy have you been taking any of the following? iron

1
Yes
2
No
B5 b

During this pregnancy have you been taking any of the following? zinc

1
Yes
2
No
B5 c

During this pregnancy have you been taking any of the following? calcium

1
Yes
2
No
B5 d

During this pregnancy have you been taking any of the following? folic acid/folate

1
Yes
2
No
B5 e

During this pregnancy have you been taking any of the following? vitamins (please name brand)

1
Yes
2
No
Generic text
B5 f

During this pregnancy have you been taking any of the following? other supplements or diet foods (please describe)

1
Yes
2
No
Other
B6 a

Do you ever take homeopathic medicines?

1
Yes often
2
Yes sometimes
3
No
If yes,
qc_B6_a == 1
B6 b

please describe:

Generic text
B7 a
Please indicate how often you have taken the following pills during this pregnancy.
-

1 - Every day

2 - Most days

3 - Sometimes

4 - Not at all
aspirin
paracetamol
codeine/anadin
mogadon, or other sleeping tablets
valium, or other tranquillisers
B7 b
Please describe all pills, medicines and ointments you have taken or used in the past 3 months.
What did you take: About how many days did you take or use it? How many weeks pregnant were you?
How manyHow manyGeneric textHow manyHow manyGeneric textHow manyGeneric textHow many How manyHow manyGeneric textHow manyHow manyGeneric textHow manyGeneric textHow many How manyHow manyGeneric textHow manyHow manyGeneric textHow manyGeneric textHow many
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Check Have you included the contraceptive pill, iron tablets, laxatives, vitamins, sleeping tablets, aspirin, cough mixture, pain killers, herbal medicine?
SECTION C: YOUR REACTIONS TO BECOMING A PARENT
C1 a

Were you deliberately trying to get pregnant this time?

1
Yes
2
No
If no, go to Question C2.
If yes,
qc_C1_a ==1
C1 b

for how long had you been trying?

1
under 6 months
2
6-11 months
3
1-2 years
4
3 years or more
C2

How would you describe your reaction when you first found you were pregnant?

(tick one only)

1
overjoyed
2
pleased
3
mixed feelings
4
not happy
5
very unhappy
6
no particular feelings
C3 a

Does being a mother mean giving up something that is important to you? ... Please add any extra comments you wish to make:

1
yes, a great deal
2
yes, quite a lot
3
not really
4
definitely not
9
don't know
Generic text
C3 b

Does becoming a mother give you new opportunities and interests? ... Please add any extra comments you wish to make:

1
yes, a great deal
2
yes, quite a lot
3
not really
4
definitely not
9
don't know
Generic text
C4

How do you feel about your pregnancy now?

1
overjoyed
2
pleased
3
mixed feelings
4
not happy
5
very unhappy
6
no particular feelings
C5

How do you think your partner feels about your pregnancy?

1
overjoyed
2
pleased
3
mixed feeling
4
not happy
5
very unhappy
6
no particular feelings
7
have no partner
C6 i

How has your partner reacted to you since you became pregnant? When he first knew

1
supportive
2
indifferent
3
resentful
7
have no partner
4
other (please describe)
Other
C6 ii

How has your partner reacted to you since you became pregnant? Now

1
supportive
2
indifferent
3
resentful
7
have no partner
4
other (please describe)
Other
C7

Do you want a boy or girl?

1
boy
2
girl
3
don't mind
C8

Do you think your partner wants a boy or girl?

1
boy
2
girl
3
doesn't mind
4
he doesn't know I'm pregnant yet
7
I have no partner
SECTION D: YOUR FEELINGS
The questions in this section ask you about your feelings and behaviour. Please indicate the way you feel at this stage in your pregnancy.
D1

Do you feel upset for no obvious reason?

1
Very often
2
Often
3
Not very often
4
Never
D2

Do you get troubled by dizziness or shortness of breath?

1
Very often
2
Often
3
Not very often
4
Never
D3

Have you felt as though you might faint?

1
Very often
2
Often
3
Not very often
4
Never
D4

Do you feel sick or have indigestion?

1
Very often
2
Often
3
Not very often
4
Never
D5

Do you feel that life is too much effort?

1
Very often
2
Often
3
Not very often
4
Never
D6

Do you feel uneasy and restless?

1
Very often
2
Often
3
Not very often
4
Never
D7

Do you feel tingling or prickling sensations in your body, arms or legs?

1
Very often
2
Often
3
Not very often
4
Never
D8

Do you regret much of your past behaviour?

1
Very often
2
Often
3
Not very often
4
Never
D9

Do you sometimes feel panicky?

1
Very often
2
Often
3
Not very often
4
Never
D10

Do you find that you have little or no appetite?

1
Very often
2
Often
3
Not very often
4
Never
D11

Do you wake unusually early in the morning?

1
Very often
2
Often
3
Not very often
4
Never
D12

Do you worry a lot?

1
Very often
2
Often
3
Not very often
4
Never
D13

Do you feel tired or exhausted?

1
Very often
2
Often
3
Not very often
4
Never
D14

Do you experience long periods of sadness?

1
Very often
2
Often
3
Not very often
4
Never
D15

Do you feel strung-up inside?

1
Very often
2
Often
3
Not very often
4
Never
D16

Can you get off to sleep alright?

1
Very often
2
Often
3
Not very often
4
Never
D17

Do you ever have the feeling you are going to pieces?

1
Very often
2
Often
3
Not very often
4
Never
D18

Do you often have excessive sweating or fluttering of the heart?

1
Very often
2
Often
3
Not very often
4
Never
D19

Do you find yourself needing to cry?

1
Very often
2
Often
3
Not very often
4
Never
D20

Do you have bad dreams which upset you when you wake up?

1
Very often
2
Often
3
Not very often
4
Never
D21

Do you lose the ability to feel sympathy for others?

1
Very often
2
Often
3
Not very often
4
Never
D22

Can you think quickly?

1
Very often
2
Often
3
Not very often
4
Never
D23

Do you have to make a special effort to face up to a crisis or difficulty?

1
Very often
2
Often
3
Not very often
4
Never
Your feelings in the past week.
D24

I have been able to laugh and see the funny side of things:

1
As much as I always could
2
Not quite so much now
3
Definitely not so much now
4
Not at all
D25

I have looked forward with enjoyment to things:

1
As much as I ever did
2
Rather less than I used to
3
Definitely less than I used to
4
Hardly at all
D26

I have blamed myself unnecessarily when things went wrong:

1
Yes, most of the time
2
Yes, some of the time
3
Not very often
4
No never
D27

I have been anxious or worried for no good reason:

1
No, not at all
2
Hardly ever
3
Yes, sometimes
4
Yes, often
In the past week:
D28

I have felt scared or panicky for no very good reason:

1
Yes, quite a lot
2
Yes, sometimes
3
No, not much
4
No, not at all
D29

Things have been getting on top of me:

1
Yes, most of the time
2
Yes, sometimes
3
No, hardly ever
4
No, not at all
D30

I have been so unhappy that I have had difficulty sleeping:

1
Yes, most of the time
2
Yes, sometimes
3
Not very often
4
No, not all
D31

I have felt sad or miserable:

1
Yes, most of the time
2
Yes, quite often
3
Not very often
4
No, not at all
In the past week:
D32

I have been so unhappy that I have been crying:

1
Yes, most of the time
2
Yes, quite often
3
Only occasionally
4
No, never
D33

The thought of harming myself has occurred to me:

1
Yes, quite often
2
Sometimes
3
Hardly ever
4
Never
D34 a

Since you became pregnant have you noticed any change in: How irritable you are

1
Yes, increased a lot
2
Yes, increased a little
3
No change
4
Yes decreased a little
5
Yes decreased a lot
D34 b

Since you became pregnant have you noticed any change in: How nervous you are

1
Yes, increased a lot
2
Yes, increased a little
3
No change
4
Yes decreased a little
5
Yes decreased a lot
D34 c

Since you became pregnant have you noticed any change in: How healthy you are

1
Yes, increased a lot
2
Yes, increased a little
3
No change
4
Yes decreased a little
5
Yes decreased a lot
D34 d

Since you became pregnant have you noticed any change in: How communicative you are

1
Yes, increased a lot
2
Yes, increased a little
3
No change
4
Yes decreased a little
5
Yes decreased a lot
D34 e

Since you became pregnant have you noticed any change in: How active you are

1
Yes, increased a lot
2
Yes, increased a little
3
No change
4
Yes decreased a little
5
Yes decreased a lot
D34 f

Since you became pregnant have you noticed any change in: How able you are to think and concentrate

1
Yes, increased a lot
2
Yes, increased a little
3
No change
4
Yes decreased a little
5
Yes decreased a lot
D34 g

Since you became pregnant have you noticed any change in: How physically attractive you are

1
Yes, increased a lot
2
Yes, increased a little
3
No change
4
Yes decreased a little
5
Yes decreased a lot
D35 a

How frequently in the past few weeks have you been: Irritable

1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D35 b

How frequently in the past few weeks have you been: Nervous

1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D35 c

How frequently in the past few weeks have you been: Active

1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D35 d

How frequently in the past few weeks have you been: In good health

1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D35 e

How frequently in the past few weeks have you been: Communicative

1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D35 f

How frequently in the past few weeks have you been: Able to think and concentrate

1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D35 g

How frequently in the past few weeks have you been: Feeling attractive

1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
IF YOU HAVE NO PARTNER, PLEASE PUT A LINE THROUGH QUESTIONS D36 AND D37, AND THEN GO TO QUESTION E1 ON PAGE 21.
D36 a-g
Since becoming pregnant have you noticed any change in your partner in any of the following?
-

1 - Yes, increased a lot

2 - Yes, increased a little

3 - No change

4 - Yes decreased a little

5 - Yes decreased a lot
How irritable he is
How nervous he is
How healthy he is
How communicative he is
How active he is
How able he is to think and concentrate
How physically attractive he is
D37 a

How frequently in the past few weeks has he been: Irritable

1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D37 b

How frequently in the past few weeks has he been: Nervous

1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D37 c

How frequently in the past few weeks has he been: Active

1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D37 d

How frequently in the past few weeks has he been: In good health

1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D37 e

How frequently in the past few weeks has he been: Communicative

1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D37 f

How frequently in the past few weeks has he been: Able to think and concentrate

1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D37 g

How frequently in the past few weeks has he been: Looking attractive

1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
SECTION E: OCCUPATION
E1 a

Have you ever had a paid job?

1
Yes
2
No
If no, go to E5, on page 23.
If yes,
qc_E1_a == 1
E1 b

Are you currently working?

1
Yes
2
No
If yes, go to E2.
If no,
qc_E1_b == 2
E1 c

What date did you stop work?

Generic date
E1 d

Why did you stop work at this time?

1
ill health/tiredness
2
looking after children/preparing for baby
3
made redundant
4
didn't like the job
5
moved house
6
other
Other
E1 e

Are you now on paid maternity leave?

1
Yes
2
No
E2 a

What is your present job? If you are not working, what was your most recent job?

Generic text
E2 b

Are/were you working:

1
full-time
2
part-time
3
casually
E2 c

type of industry or service given:

Generic text
E2 d

Do/did you do shift work?

1
Yes
2
No
If yes,
qc_E2_d == 1
E2 e

does/did this include night shift

1
Yes
2
No
If you have not worked at all this pregnancy, go to E5
Else
E3 a-f
What is your job like: (If you are no longer working answer for your most recent job this pregnancy).
-

1 - Yes, always

2 - Yes, mostly

3 - Sometimes

4 - Not very often

5 - Never
Do you enjoy your job?
Do you have problems at work?
Are the people at your work friendly?
Are the people at your work supportive?
Is it very noisy?
Do you work in a smoky atmosphere?
E4 a

About how long does/did it take you altogether to travel, to get to work each day?

Hours Minutes
E4 b

About how long does/did it take you altogether to travel, to get back from work each day?

Hours Minutes
E4 c

How do/did you travel to work?

1
By foot
2
By public transport
3
By bicycle
4
By car
5
Work at home
6
Other(please describe)
Other
E5 a-h
In the year before this pregnancy, in the first months of this pregnancy, and now did/do you do any of the following (whether at home, at school, at work or elsewhere):
In the year before this pregnancy In the first 3 months of this pregnancy From 4 months of this pregnancy until now

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No
Did/do you use a VDU? (television type screen)
Are/were you mostly sitting?
Are/were you bending a lot?
Are/were you standing much of the time?
Are/were you doing repetitive, boring tasks?
Did/does your job involve challenging and mentally demanding tasks?
Are/were you using a lot of physical energy?
In your job are/were you in contact with fumes or chemicals? (please describe)
E5 h

In the year before this pregnancy, in the first months of this pregnancy, and now did/do you do any of the following (whether at home, at school, at work or elsewhere): In your job are/were you in contact with fumes or chemicals? (please describe)

Generic text
[Please make sure you have answered each of the three columns]
SECTION F: RECENT EVENTS
Listed below are a number of events which may have brought changes in your life. Have any of these occurred since you became pregnant ? If so, please assess how much effect it had on you.
F1

Since becoming pregnant: Your partner died

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F2

Since becoming pregnant: One of your children died

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F3

Since becoming pregnant: A friend or relative died

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F4

Since becoming pregnant: One of your children was ill

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F5

Since becoming pregnant: Your partner was ill

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F6

Since becoming pregnant: A friend or relative was ill

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F7

Since becoming pregnant: You were admitted to hospital

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F8

Since becoming pregnant: You were in trouble with the law

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F9

Since becoming pregnant: You were divorced

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F10

Since becoming pregnant: You found that your partner didn't want your child

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F11

Since becoming pregnant: You were very ill

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F12

Since becoming pregnant: Your partner lost his job

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F13

Since becoming pregnant: Your partner had problems at work

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F14

Since becoming pregnant: You had problems at work

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F15

Since becoming pregnant: You lost your job

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F16

Since becoming pregnant: Your partner went away

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F17

Since becoming pregnant: Your partner was in trouble with the law

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F18

Since becoming pregnant: You and your partner separated

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F19

Since becoming pregnant: Your income was reduced

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F20

Since becoming pregnant: You argued with your partner

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F21

Since becoming pregnant: You had arguments with your family or friends

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F22

Since becoming pregnant: You moved house

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F23

Since becoming pregnant: Your partner hurt you physically

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F24

Since becoming pregnant: You became homeless

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F25

Since becoming pregnant: You had a major financial problem

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F26

Since becoming pregnant: You got married

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F27

Since becoming pregnant: Your partner hurt your children physically

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F28

Since becoming pregnant: You attempted suicide

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F29

Since becoming pregnant: You were convicted of an offence

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F30

Since becoming pregnant: You were bleeding and thought you might miscarry

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F31

Since becoming pregnant: You started a new job

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F32

Since becoming pregnant: You had a test to see if your baby was abnormal

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F33

Since becoming pregnant: You had a result on a test that suggested your baby might not be normal

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F34

Since becoming pregnant: You were told that you were going to have twins

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F35

Since becoming pregnant: You heard that something that had happened might be harmful to the baby

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F36

Since becoming pregnant: You tried to have an abortion

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F37

Since becoming pregnant: You took an examination

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F38

Since becoming pregnant: Your partner was emotionally cruel to you

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F39

Since becoming pregnant: Your partner was emotionally cruel to your children

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F40

Since becoming pregnant: Your house or car was burgled

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F41

Since becoming pregnant: You had an accident

1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F42 a

Is there anything else which is not on the list which has concerned you or required additional effort from you to cope since becoming pregnant?

1
Yes
2
No
If no go to F43.
If yes,
qc_F42_a == 1
F42 b

please describe :

Generic text
F42 c

How did this affect you?

1
a lot
2
moderately
3
mildly
4
not at all
F43

Becoming pregnant is an important event. How did this affect you?

1
a lot
2
moderately
3
mildly
4
not at all
SECTION G: ACTIVITIES AND LIFESTYLE
G1 a-c
Which of the following statements best applied to you just before you became pregnant, in the early months and now.
-

1 - Very energetic

2 - Quite energetic

3 - Lacking in energy
before you became pregnant
in the first 3 months
now
G1 d

Compared with other pregnant women of your age, would you consider yourself to be:

1
much more active
2
somewhat more active
3
about the same
4
somewhat less active
5
much less active
G1 e

Nowadays, at least once a week do you engage in any regular activity like brisk walking, gardening, housework, jogging, cycling, etc. long enough to work up a sweat?

1
Yes
2
No
If yes,
qc_G1_e == 1
G1 f

how many hours a week: ... hours

How many
G2 a-e
In a normal day now, whether at home or not, how often do you:
-

1 - Often

2 - Occasionally

3 - Not at all
lift and carry heavy objects (more than 10Kg.)
lift and carry young children
bend and stoop
have rest periods
use vibrating machinery
G3 a

Have you ever been a smoker?

1
Yes
2
No
If no, please go to G4, on page 30.
If yes,
qc_G3_a == 1
G3 b

at what age did you start smoking regularly? ... years

Age
G3 c(i)

which of the following have you smoked regularly? cigarette

1
Yes
2
No
G3 c(ii)

which of the following have you smoked regularly? pipe

1
Yes
2
No
G3 c(iii)

which of the following have you smoked regularly? cigar

1
Yes
2
No
G3 c(iv)

which of the following have you smoked regularly? other

1
Yes
2
No
G3 d

What was the maximum number of times a day you smoked?

30
30+
25
25-29
20
20-24
15
15-19
10
10-14
05
5-9
01
1-4
00
0
G3 e

Have you now stopped smoking?

1
Yes
2
No
If yes,
qc_G3_e == 1
G3 e(i)

how long ago? ... years ... months

Year
Month
G3 f(i)

Did you smoke regularly at any of the following times in the last 9 months? Before pregnancy

1
No
2
Yes, cigarettes
3
Yes, cigars
4
Yes, pipe
5
Yes, other (please describe)
Other
G3 f(ii)

Did you smoke regularly at any of the following times in the last 9 months? First 3 months of pregnancy

1
No
2
Yes, cigarettes
3
Yes, cigars
4
Yes, pipe
5
Yes, other (please describe)
Other
G3 f(iii)

Did you smoke regularly at any of the following times in the last 9 months? Last 2 weeks

1
No
2
Yes, cigarettes
3
Yes, cigars
4
Yes, pipe
5
Yes, other (please describe)
Other
G3 g(i)

how many times per day did you smoke - just before you became pregnant per day

30
30+
25
25-29
20
20-24
15
15-19
10
10-14
05
5-9
01
1-4
00
0
G3 g(ii)

how many times per day did you smoke - in the first 3 months of your pregnancy per day

30
30+
25
25-29
20
20-24
15
15-19
10
10-14
05
5-9
01
1-4
00
0
G3 g(iii)

how many times per day did you smoke - in the last 2 weeks? per day

30
30+
25
25-29
20
20-24
15
15-19
10
10-14
05
5-9
01
1-4
00
0
G3 h(i)

What brand and type of cigarette or tobacco do/did you usually smoke? brand:

Generic text
G3 h(ii)

What brand and type of cigarette or tobacco do/did you usually smoke? type:

1
filtered
2
unfiltered
3
roll-your-own
4
pipe/cigar
Please send us an empty packet/carton of the brand you usually smoke.
G4 a

Did your mother ever smoke?

1
Yes
2
No
9
Don't know
If yes,
qc_G4_a == 1
G4 a(i)

did she smoke when she was expecting you?

1
Yes
2
No
9
Don't know
G4 b

Did your father ever smoke?

1
Yes
2
No
9
Don't know
G5 a

Does your partner smoke?

1
No
2
Yes, cigarettes
3
Yes, cigars
4
Yes, pipe
5
Yes, other (please describe)
7
Don't have a partner
Other
If no, or don't have a partner, go to G6 on page 31.
If yes,
qc_G5_a > 1 && qc_G5_a < 6
G5 b

about how many times per day does your partner smoke at the moment?

30
30+
25
25-29
20
20-24
15
15-19
10
10-14
05
5-9
01
1-4
99
don't know
G5 c(i)

what brand, and type of cigarette/tobacco does your partner smoke? brand:

Generic text
G5 c(ii)

what brand, and type of cigarette/tobacco does your partner smoke? type:

1
filtered
2
unfiltered
3
roll-your-own
4
pipe/cigar
G5 d

at what age did your partner start smoking? ... years

Age
99
G6 a

Apart from yourself and your partner, are there any other members of your household who smoke?

1
Yes
2
No
If yes,
qc_G6_a == 1
G6 b

how many:

How many
G7 a

How often did you smoke marijuana/grass/cannabis/ ganja - In the 6 months before you conceived

1
Every day
2
2-4 times a week
3
Once a week
4
Less than once a week
5
Not at all
G7 b

How often did you smoke marijuana/grass/cannabis/ ganja - In the first 3 months of pregnancy

1
Every day
2
2-4 times a week
3
Once a week
4
Less than once a week
5
Not at all
G7 c

How often did you smoke marijuana/grass/cannabis/ ganja - Between 3 months and now

1
Every day
2
2-4 times a week
3
Once a week
4
Less than once a week
5
Not at all
G8 a

How often have you taken the following during this pregnancy: amphetamines

1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
G8 b

How often have you taken the following during this pregnancy: barbiturates

1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
G8 c

How often have you taken the following during this pregnancy: crack

1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
G8 d

How often have you taken the following during this pregnancy: cocaine

1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
G8 e

How often have you taken the following during this pregnancy: heroin

1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
G8 f

How often have you taken the following during this pregnancy: methadone

1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
G8 g

How often have you taken the following during this pregnancy: ecstasy

1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
G8 h

How often have you taken the following during this pregnancy: other (please describe)

1
Nearly every day
2
At least once a week
3
At least once a month
4
Not at all
Other
G9 a-c
How often have you drunk alcoholic drinks? Please indicate for each of the following times:
-

1 - Never

2 - Less than 1 glass* a week

3 - At least 1 glass* a week

4 - 1-2 glasses* every day

5 - At least 3-9 glasses* every day

6 - At least 10 glasses* every day
Before this pregnancy
1st 3 months of this pregnancy
At around the time you first felt the baby move
(If you haven't felt the baby move yet, please answer for the last two weeks)
* [By glass we mean a pub measure of spirits, half a pint of lager or cider, a wine glass of wine, etc]
G10

How many days in the past month have you drunk the equivalent of 2 pints of beer, 4 glasses of wine or 4 pub measures of spirit?

5
everyday
4
more than 10 days
3
5-10 days
2
3-4 days
1
1-2 days
0
None
G11

Which is the alcoholic drink you have most often drunk during this pregnancy?

(tick one only)

1
wine
2
beer/lager
3
sherry/port
4
gin/whisky/vodka/brandy
5
other (please describe)
7
don't drink at all
Other
G12

How would you describe your partner's alcohol drinking? Which of the following statements best applies:

1
Never drinks alcohol
2
Very occasionally (less than once a week)
3
Occasionally (at least once a week)
4
Drinks 1-2 glasses nearly every day
5
Drinks 3-9 glasses every day
6
Drinks at least 10 glasses a day
7
Don't have a partner
9
Don't know
G13 a-l
At present how much of the following do you usually drink in a day:
Weekday Weekend day
How manyHow manyHow manyHow many How manyHow manyHow manyHow many
ordinary tea (cups)
decaffeinated tea (cups)
coffee (cups)
decaffeinated coffee (cups)
beer or lager (half-pints)
wine (glasses)
spirits (pub-measures)
cola/pepsi (cans)
decaffeinated cola/pepsi cans
other alcoholic drinks (pub measures)
milk (glasses)
other drinks (please describe)
G13 l

At present how much of the following do you usually drink in a day: other drinks (please describe)

Other
G14 a

Have you ever actually made yourself sick (vomit) because you wanted to lose weight or because you had eaten too much?

1
Yes
2
No
If yes,
qc_G14_a == 1
G14 b

how often have you made yourself vomit during this pregnancy?

5
not at all
1
once
2
2-4 times
3
5-14 times
4
15 or more times
G15 a

Have you ever taken laxatives because you wanted to lose weight or because you had eaten too much?

1
Yes
2
No
If yes,
qc_G15_a == 1
G15 b

how often have you done so during this pregnancy?

5
not at all
1
once
2
2-4 times
3
5-14 times
4
15 or more times
OVER THE PAST FOUR WEEKS (28 DAYS)
G16 a

Has thinking about your shape or weight interfered with your ability to concentrate on things?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G16 b

Have you been afraid that you may become fat?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G16 c

Have you felt fat?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G16 d

Have you had a strong desire to lose weight?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G16 e

Has your weight influenced how you think about yourself as a person?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G16 f

Have you felt dissatisfied about your weight?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G16 g

Have you felt dissatisfied about your shape?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G16 h

Have you felt concerned about other people seeing you eat?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G16 i

Have you felt uncomfortable seeing your body in the mirror?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G16 j

Have you experienced a loss of control over eating?

1
Not at all
2
Yes occasionally
3
Yes most of the time
IN THE THREE MONTHS BEFORE YOU BECAME PREGNANT
G17 a

Did thinking about your shape or weight interfere with your ability to concentrate on things?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G17 b

Were you afraid that you might become fat?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G17 c

Did you feel fat?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G17 d

Did you have a strong desire to lose weight?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G17 e

Did your weight influence how you thought about yourself as a person?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G17 f

Did you feel dissatisfied about your weight?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G17 g

Did you feel dissatisfied about your shape?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G17 h

Did you feel concerned about other people seeing you eat?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G17 i

Did you feel uncomfortable seeing your body in the mirror?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G17 j

Did you experience a loss of control over eating?

1
Not at all
2
Yes occasionally
3
Yes most of the time
G18

Which of the following statements describes best the way in which you travel nowadays?

1
usually walk everywhere
2
cycle mostly
3
usually get in a car
4
mostly use public transport
G19 a

How much do you do the following at present? jogging

1
More than 7 hours per week
2
2-6 hours per week
3
Less than one hour per week
4
Never
G19 b

How much do you do the following at present? aerobics

1
More than 7 hours per week
2
2-6 hours per week
3
Less than one hour per week
4
Never
G19 c

How much do you do the following at present? ante-natal exercises

1
More than 7 hours per week
2
2-6 hours per week
3
Less than one hour per week
4
Never
G19 d

How much do you do the following at present? keep fit exercises

1
More than 7 hours per week
2
2-6 hours per week
3
Less than one hour per week
4
Never
G19 e

How much do you do the following at present? yoga

1
More than 7 hours per week
2
2-6 hours per week
3
Less than one hour per week
4
Never
G19 f

How much do you do the following at present? squash

1
More than 7 hours per week
2
2-6 hours per week
3
Less than one hour per week
4
Never
G19 g

How much do you do the following at present? tennis/badminton

1
More than 7 hours per week
2
2-6 hours per week
3
Less than one hour per week
4
Never
G19 h

How much do you do the following at present? swimming

1
More than 7 hours per week
2
2-6 hours per week
3
Less than one hour per week
4
Never
G19 i

How much do you do the following at present? brisk walking

1
More than 7 hours per week
2
2-6 hours per week
3
Less than one hour per week
4
Never
G19 j

How much do you do the following at present? weight training

1
More than 7 hours per week
2
2-6 hours per week
3
Less than one hour per week
4
Never
G19 k

How much do you do the following at present? cycling

1
More than 7 hours per week
2
2-6 hours per week
3
Less than one hour per week
4
Never
G19 l

How much do you do the following at present? other exercise (please describe)

1
More than 7 hours per week
2
2-6 hours per week
3
Less than one hour per week
4
Never
Other
SECTION H: ABOUT YOURSELF
H1

In general: I feel insecure when I say goodbye to people

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H2

In general: I worry about the effect I have on other people

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H3

In general: I avoid saying what I think for fear of being rejected

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H4

In general: I feel uneasy meeting new people

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H5

In general: If others knew the real me, they would not like me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H6

In general: I feel secure when I'm in a close relationship

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H7

In general: I don't get angry with people for fear that I may hurt them

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H8

In general: After a row with a friend, I feel uncomfortable until I have made peace

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H9

In general: I am always aware of how other people feel

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H10

In general: I worry about being criticised for things I have said or done

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H11

In general: I always notice if someone doesn't respond to me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H12

In general: I worry about losing someone close to me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H13

In general: I feel that people generally like me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H14

In general: I will do something I don't want to do rather than offend or upset someone

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H15

In general: I can only believe that something I have done is good when someone tells me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H16

In general: I will go out of my way to please someone I am close to

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H17

In general: I feel anxious when I say goodbye to people

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H18

In general: I feel happy when someone compliments me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H19

In general: I fear that my feelings will overwhelm me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H20

In general: I can make other people feel happy

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H21

In general: I find it hard to get angry with people

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H22

In general: I worry about criticising people

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H23

In general: If someone is critical of something I do, I feel bad

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H24

In general: If other people knew what I am really like, they would think less of me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H25

In general: I always expect criticism

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H26

In general: I can never be really sure if someone is pleased with me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H27

In general: I don't like people to really know me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H28

In general: If someone upsets me, I am not able to put it easily out of my mind

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H29

In general: I feel others do not understand me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H30

In general: I worry about what others think of me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H31

In general: I don't feel happy unless people I know admire me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H32

In general: I am never rude to anyone

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H33

In general: I worry about hurting the feelings of other people

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H34

In general: I feel hurt when someone is angry with me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H35

In general: My value as a person depends enormously on what others think of me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
H36

In general: I care about what people feel about me

1
Very like me
2
Moderately like me
3
Moderately unlike me
4
Very unlike me
SECTION I
I1

Please put the date of completing this questionnaire:

Generic date
I2

Please give your date of birth:

Generic date
N.B. Have you remembered to enclose an empty cigarette packet?
I i

Space for any comments you might like to make:

Generic text
VERY MANY THANKS FOR ALL YOUR HELP
When completed, put in the envelope provided and either bring to the clinic or post to:
Dr. Jean Golding, Children of the Nineties - ALSPAC, Institute of Child Health, 24 Tyndall Avenue, Bristol. BS8 1BR.
Please remember, because this is strictly confidential, the people who look at this booklet will not know your name. They will be unable to give you any help or contact anyone after reading what you have written. If you feel you need advice, please feel free to contact our hotline (Bristol 256260, during office hours). Alternatively your General Practitioner should be able to advise you.
End

alspac_91_hab

s_intro_i
HAVING A BABY
s_intro_ii
This questionnaire asks about how you have been feeling so far in your pregnancy.
s_intro_iii
Your answers are confidential. Your name will not be on the questionnaire and none of the doctors or nurses you see will know your answers.
s_intro_iv
Please answer all the questions you can. If there are any you cannot answer or do not wish to answer that is fine. Just leave them blank.
s_intro_v
THANK YOU VERY MUCH FOR YOUR HELP

SECTION A: YOUR PREVIOUS PREGNANCIES

A1
Have you ever been pregnant before?
1
Yes
2
No
s_qA1
If no, go to Section B, on page 6.
A2 a
How many times have you been pregnant altogether before this time?
How many
If yes,
A2 b
Is this the first pregnancy with your present partner?
1
Yes
2
No
9
Am not sure
If yes,
A3 a
How many children still living, of your own do you have?
How many
If yes,
A3 b
Do they all live with you?
1
Yes
2
No
7
Don't have children
If yes,
A4 a
Have you ever had any miscarriages?
1
Yes
2
No
If yes,
A4 b
how many times have you miscarried?
How many
If yes,
If yes,
A5 a
Have you ever had any abortions or terminations?
1
Yes
2
No
If yes,
A5 b
how many ?
How many
If yes,
If yes,
A6 a
Have you ever had a stillborn baby ?
1
Yes
2
No
If yes,
A6 b
how many?
How many
If yes,
If yes,
A7 a
Have you ever had any babies who were born alive but died later?
1
Yes
2
No
If yes,
A7 b
how many?
How many
If yes,
If yes, please describe:
A7 c
what caused their death?
Generic text
If yes,
If yes, please describe:
A7 d
how old were they when they died?
Generic text
If yes,
If yes, please describe:
A8
Were any of your babies under 5lb 8oz (2500 grammes) at birth?
1
Yes
2
No
9
Don't know
If yes,
A9 a
Were any of your babies born more than 3 weeks early?
1
Yes
2
No
9
Don't know
If yes,
A9 b
Have you ever had a caesarean section?
1
Yes
2
No
9
Don't know
If yes,
A10
How old were you when you became pregnant for the very first time? ... years
Age
If yes,
A11 a
What was the outcome of the last pregnancy before this pregnancy?
1
miscarriage
2
abortion or termination
3
stillbirth
4
liveborn baby that died
5
liveborn baby still alive
6
other (please describe)
Other
If yes,
A11 b
Please give the date of your last birth/miscarriage/abortion or termination before this pregnancy:
Generic date
If yes,
A11 c
Did you breast feed your last baby?
1
Yes
2
No
7
Have not had a baby
If yes,
A11 d
for how long?
1
under 1 month
2
1-3 months
3
more than 3 months
If yes,
If yes,

SECTION B: YOUR HEALTH

B1 a
How would you describe your health: up to the time of your present pregnancy
1
Always fit & well
2
Usually fit & well
3
Sometimes unwell
4
Often unwell
5
Always unwell
B1 b
How would you describe your health: in the first months of this pregnancy
1
Always fit & well
2
Usually fit & well
3
Sometimes unwell
4
Often unwell
5
Always unwell
B1 c
How would you describe your health: in the last two weeks
1
Always fit & well
2
Usually fit & well
3
Sometimes unwell
4
Often unwell
5
Always unwell
B2 a
During this pregnancy so far have you had any of the following: nausea
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 b
During this pregnancy so far have you had any of the following: vomiting
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 c
During this pregnancy so far have you had any of the following: diarrhoea
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 d
During this pregnancy so far have you had any of the following: vaginal bleeding
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 e
During this pregnancy so far have you had any of the following: jaundice
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 f
During this pregnancy so far have you had any of the following: urinary infection
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 g
During this pregnancy so far have you had any of the following: influenza
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 h
During this pregnancy so far have you had any of the following: rubella (german measles)
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 j
During this pregnancy so far have you had any of the following: thrush (candida)
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 k
During this pregnancy so far have you had any of the following: genital herpes
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 l
During this pregnancy so far have you had any of the following: other infection (please describe)
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
Other
B2 m
During this pregnancy: injury or shock to you (please describe)
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
Generic text
B2 n
During this pregnancy: sugar in urine
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 o
During this pregnancy: x-ray
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 p
During this pregnancy: amniocentesis
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 q
During this pregnancy: chorionic villus sampling (CVS)
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 r
During this pregnancy: AFP test (spina bifida test)
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B2 s
During this pregnancy: ultrasound scan
1
Yes,in 1st 3 months
2
Yes in period 4 months to now
4
No, not at all
9
Don't know
B3 a
Have you been admitted to hospital during this pregnancy?
1
Yes
2
No
s_qB3_a
If no, go to B4, on page 8.
B3 b

give reason for each admission:

Reason Date admitted Number of days stayed
Generic textHow manyGeneric dateGeneric textHow manyGeneric dateHow manyGeneric dateGeneric text Generic textHow manyGeneric dateGeneric textHow manyGeneric dateHow manyGeneric dateGeneric text Generic textHow manyGeneric dateGeneric textHow manyGeneric dateHow manyGeneric dateGeneric text
1
2
3
4
5
If yes,
B4 a-o

During this pregnancy have you ever taken any medicines, pills or used ointment or suppositories for the following:

-

1 - Yes, taken in 1st 3 months of pregnancy

2 - Yes, taken later in pregnancy

4 - No, not at all
nausea
heartburn
vomiting
anxiety
infection
migraine
difficulty going to sleep
pain
allergies
skin condition
bleeding
depression
piles
constipation
cough
B4 p
During this pregnancy have you ever taken any medicines, pills or used ointment or suppositories for the following: Medicines, pills or ointments for: other reason (please describe)
1
Yes, taken in 1st 3 months of pregnancy
2
Yes, taken later in pregnancy
4
No, not at all
Other
B5 a
During this pregnancy have you been taking any of the following? iron
1
Yes
2
No
B5 b
During this pregnancy have you been taking any of the following? zinc
1
Yes
2
No
B5 c
During this pregnancy have you been taking any of the following? calcium
1
Yes
2
No
B5 d
During this pregnancy have you been taking any of the following? folic acid/folate
1
Yes
2
No
B5 e
During this pregnancy have you been taking any of the following? vitamins (please name brand)
1
Yes
2
No
Generic text
B5 f
During this pregnancy have you been taking any of the following? other supplements or diet foods (please describe)
1
Yes
2
No
Other
B6 a
Do you ever take homeopathic medicines?
1
Yes often
2
Yes sometimes
3
No
B6 b
please describe:
Generic text
If yes,
B7 a

Please indicate how often you have taken the following pills during this pregnancy.

-

1 - Every day

2 - Most days

3 - Sometimes

4 - Not at all
aspirin
paracetamol
codeine/anadin
mogadon, or other sleeping tablets
valium, or other tranquillisers
B7 b

Please describe all pills, medicines and ointments you have taken or used in the past 3 months.

What did you take: About how many days did you take or use it? How many weeks pregnant were you?
How manyHow manyGeneric textHow manyHow manyGeneric textHow manyGeneric textHow many How manyHow manyGeneric textHow manyHow manyGeneric textHow manyGeneric textHow many How manyHow manyGeneric textHow manyHow manyGeneric textHow manyGeneric textHow many
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
s_qB7_b
Check Have you included the contraceptive pill, iron tablets, laxatives, vitamins, sleeping tablets, aspirin, cough mixture, pain killers, herbal medicine?

SECTION C: YOUR REACTIONS TO BECOMING A PARENT

C1 a
Were you deliberately trying to get pregnant this time?
1
Yes
2
No
s_qC1_a
If no, go to Question C2.
C1 b
for how long had you been trying?
1
under 6 months
2
6-11 months
3
1-2 years
4
3 years or more
If yes,
C2
How would you describe your reaction when you first found you were pregnant?
1
overjoyed
2
pleased
3
mixed feelings
4
not happy
5
very unhappy
6
no particular feelings
C3 a
Does being a mother mean giving up something that is important to you? ... Please add any extra comments you wish to make:
1
yes, a great deal
2
yes, quite a lot
3
not really
4
definitely not
9
don't know
Generic text
C3 b
Does becoming a mother give you new opportunities and interests? ... Please add any extra comments you wish to make:
1
yes, a great deal
2
yes, quite a lot
3
not really
4
definitely not
9
don't know
Generic text
C4
How do you feel about your pregnancy now?
1
overjoyed
2
pleased
3
mixed feelings
4
not happy
5
very unhappy
6
no particular feelings
C5
How do you think your partner feels about your pregnancy?
1
overjoyed
2
pleased
3
mixed feeling
4
not happy
5
very unhappy
6
no particular feelings
7
have no partner
C6 i
How has your partner reacted to you since you became pregnant? When he first knew
1
supportive
2
indifferent
3
resentful
7
have no partner
4
other (please describe)
Other
C6 ii
How has your partner reacted to you since you became pregnant? Now
1
supportive
2
indifferent
3
resentful
7
have no partner
4
other (please describe)
Other
C7
Do you want a boy or girl?
1
boy
2
girl
3
don't mind
C8
Do you think your partner wants a boy or girl?
1
boy
2
girl
3
doesn't mind
4
he doesn't know I'm pregnant yet
7
I have no partner

SECTION D: YOUR FEELINGS

s_section_D
The questions in this section ask you about your feelings and behaviour. Please indicate the way you feel at this stage in your pregnancy.
D1
Do you feel upset for no obvious reason?
1
Very often
2
Often
3
Not very often
4
Never
D2
Do you get troubled by dizziness or shortness of breath?
1
Very often
2
Often
3
Not very often
4
Never
D3
Have you felt as though you might faint?
1
Very often
2
Often
3
Not very often
4
Never
D4
Do you feel sick or have indigestion?
1
Very often
2
Often
3
Not very often
4
Never
D5
Do you feel that life is too much effort?
1
Very often
2
Often
3
Not very often
4
Never
D6
Do you feel uneasy and restless?
1
Very often
2
Often
3
Not very often
4
Never
D7
Do you feel tingling or prickling sensations in your body, arms or legs?
1
Very often
2
Often
3
Not very often
4
Never
D8
Do you regret much of your past behaviour?
1
Very often
2
Often
3
Not very often
4
Never
D9
Do you sometimes feel panicky?
1
Very often
2
Often
3
Not very often
4
Never
D10
Do you find that you have little or no appetite?
1
Very often
2
Often
3
Not very often
4
Never
D11
Do you wake unusually early in the morning?
1
Very often
2
Often
3
Not very often
4
Never
D12
Do you worry a lot?
1
Very often
2
Often
3
Not very often
4
Never
D13
Do you feel tired or exhausted?
1
Very often
2
Often
3
Not very often
4
Never
D14
Do you experience long periods of sadness?
1
Very often
2
Often
3
Not very often
4
Never
D15
Do you feel strung-up inside?
1
Very often
2
Often
3
Not very often
4
Never
D16
Can you get off to sleep alright?
1
Very often
2
Often
3
Not very often
4
Never
D17
Do you ever have the feeling you are going to pieces?
1
Very often
2
Often
3
Not very often
4
Never
D18
Do you often have excessive sweating or fluttering of the heart?
1
Very often
2
Often
3
Not very often
4
Never
D19
Do you find yourself needing to cry?
1
Very often
2
Often
3
Not very often
4
Never
D20
Do you have bad dreams which upset you when you wake up?
1
Very often
2
Often
3
Not very often
4
Never
D21
Do you lose the ability to feel sympathy for others?
1
Very often
2
Often
3
Not very often
4
Never
D22
Can you think quickly?
1
Very often
2
Often
3
Not very often
4
Never
D23
Do you have to make a special effort to face up to a crisis or difficulty?
1
Very often
2
Often
3
Not very often
4
Never

Your feelings in the past week.

D24
I have been able to laugh and see the funny side of things:
1
As much as I always could
2
Not quite so much now
3
Definitely not so much now
4
Not at all
D25
I have looked forward with enjoyment to things:
1
As much as I ever did
2
Rather less than I used to
3
Definitely less than I used to
4
Hardly at all
D26
I have blamed myself unnecessarily when things went wrong:
1
Yes, most of the time
2
Yes, some of the time
3
Not very often
4
No never
D27
I have been anxious or worried for no good reason:
1
No, not at all
2
Hardly ever
3
Yes, sometimes
4
Yes, often
s_qD27
In the past week:
D28
I have felt scared or panicky for no very good reason:
1
Yes, quite a lot
2
Yes, sometimes
3
No, not much
4
No, not at all
D29
Things have been getting on top of me:
1
Yes, most of the time
2
Yes, sometimes
3
No, hardly ever
4
No, not at all
D30
I have been so unhappy that I have had difficulty sleeping:
1
Yes, most of the time
2
Yes, sometimes
3
Not very often
4
No, not all
D31
I have felt sad or miserable:
1
Yes, most of the time
2
Yes, quite often
3
Not very often
4
No, not at all
s_qD31
In the past week:
D32
I have been so unhappy that I have been crying:
1
Yes, most of the time
2
Yes, quite often
3
Only occasionally
4
No, never
D33
The thought of harming myself has occurred to me:
1
Yes, quite often
2
Sometimes
3
Hardly ever
4
Never
D34 a
Since you became pregnant have you noticed any change in: How irritable you are
1
Yes, increased a lot
2
Yes, increased a little
3
No change
4
Yes decreased a little
5
Yes decreased a lot
D34 b
Since you became pregnant have you noticed any change in: How nervous you are
1
Yes, increased a lot
2
Yes, increased a little
3
No change
4
Yes decreased a little
5
Yes decreased a lot
D34 c
Since you became pregnant have you noticed any change in: How healthy you are
1
Yes, increased a lot
2
Yes, increased a little
3
No change
4
Yes decreased a little
5
Yes decreased a lot
D34 d
Since you became pregnant have you noticed any change in: How communicative you are
1
Yes, increased a lot
2
Yes, increased a little
3
No change
4
Yes decreased a little
5
Yes decreased a lot
D34 e
Since you became pregnant have you noticed any change in: How active you are
1
Yes, increased a lot
2
Yes, increased a little
3
No change
4
Yes decreased a little
5
Yes decreased a lot
D34 f
Since you became pregnant have you noticed any change in: How able you are to think and concentrate
1
Yes, increased a lot
2
Yes, increased a little
3
No change
4
Yes decreased a little
5
Yes decreased a lot
D34 g
Since you became pregnant have you noticed any change in: How physically attractive you are
1
Yes, increased a lot
2
Yes, increased a little
3
No change
4
Yes decreased a little
5
Yes decreased a lot
D35 a
How frequently in the past few weeks have you been: Irritable
1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D35 b
How frequently in the past few weeks have you been: Nervous
1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D35 c
How frequently in the past few weeks have you been: Active
1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D35 d
How frequently in the past few weeks have you been: In good health
1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D35 e
How frequently in the past few weeks have you been: Communicative
1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D35 f
How frequently in the past few weeks have you been: Able to think and concentrate
1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D35 g
How frequently in the past few weeks have you been: Feeling attractive
1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
s_section_D_iii
IF YOU HAVE NO PARTNER, PLEASE PUT A LINE THROUGH QUESTIONS D36 AND D37, AND THEN GO TO QUESTION E1 ON PAGE 21.
D36 a-g

Since becoming pregnant have you noticed any change in your partner in any of the following?

-

1 - Yes, increased a lot

2 - Yes, increased a little

3 - No change

4 - Yes decreased a little

5 - Yes decreased a lot
How irritable he is
How nervous he is
How healthy he is
How communicative he is
How active he is
How able he is to think and concentrate
How physically attractive he is
D37 a
How frequently in the past few weeks has he been: Irritable
1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D37 b
How frequently in the past few weeks has he been: Nervous
1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D37 c
How frequently in the past few weeks has he been: Active
1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D37 d
How frequently in the past few weeks has he been: In good health
1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D37 e
How frequently in the past few weeks has he been: Communicative
1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D37 f
How frequently in the past few weeks has he been: Able to think and concentrate
1
Always
2
Often
3
Sometimes
4
Rarely
5
Never
D37 g
How frequently in the past few weeks has he been: Looking attractive
1
Always
2
Often
3
Sometimes
4
Rarely
5
Never

SECTION E: OCCUPATION

E1 a
Have you ever had a paid job?
1
Yes
2
No
s_qE1_a
If no, go to E5, on page 23.
E1 b
Are you currently working?
1
Yes
2
No
If yes,
s_qE1_b
If yes, go to E2.
If yes,
E1 c
What date did you stop work?
Generic date
If yes,
If no,
E1 d
Why did you stop work at this time?
1
ill health/tiredness
2
looking after children/preparing for baby
3
made redundant
4
didn't like the job
5
moved house
6
other
Other
If yes,
If no,
E1 e
Are you now on paid maternity leave?
1
Yes
2
No
If yes,
If no,
E2 a
What is your present job? If you are not working, what was your most recent job?
Generic text
If yes,
E2 b
Are/were you working:
1
full-time
2
part-time
3
casually
If yes,
E2 c
type of industry or service given:
Generic text
If yes,
E2 d
Do/did you do shift work?
1
Yes
2
No
If yes,
E2 e
does/did this include night shift
1
Yes
2
No
If yes,
If yes,
E3 a-f

What is your job like: (If you are no longer working answer for your most recent job this pregnancy).

-

1 - Yes, always

2 - Yes, mostly

3 - Sometimes

4 - Not very often

5 - Never
Do you enjoy your job?
Do you have problems at work?
Are the people at your work friendly?
Are the people at your work supportive?
Is it very noisy?
Do you work in a smoky atmosphere?
If yes,
E4 a
About how long does/did it take you altogether to travel, to get to work each day?
Hours Minutes
If yes,
E4 b
About how long does/did it take you altogether to travel, to get back from work each day?
Hours Minutes
If yes,
E4 c
How do/did you travel to work?
1
By foot
2
By public transport
3
By bicycle
4
By car
5
Work at home
6
Other(please describe)
Other
If yes,
E5 a-h

In the year before this pregnancy, in the first months of this pregnancy, and now did/do you do any of the following (whether at home, at school, at work or elsewhere):

In the year before this pregnancy In the first 3 months of this pregnancy From 4 months of this pregnancy until now

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No
Did/do you use a VDU? (television type screen)
Are/were you mostly sitting?
Are/were you bending a lot?
Are/were you standing much of the time?
Are/were you doing repetitive, boring tasks?
Did/does your job involve challenging and mentally demanding tasks?
Are/were you using a lot of physical energy?
In your job are/were you in contact with fumes or chemicals? (please describe)
E5 h
In the year before this pregnancy, in the first months of this pregnancy, and now did/do you do any of the following (whether at home, at school, at work or elsewhere): In your job are/were you in contact with fumes or chemicals? (please describe)
Generic text
s_qE5
[Please make sure you have answered each of the three columns]

SECTION F: RECENT EVENTS

s_qF1
Listed below are a number of events which may have brought changes in your life. Have any of these occurred since you became pregnant ? If so, please assess how much effect it had on you.
F1
Since becoming pregnant: Your partner died
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F2
Since becoming pregnant: One of your children died
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F3
Since becoming pregnant: A friend or relative died
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F4
Since becoming pregnant: One of your children was ill
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F5
Since becoming pregnant: Your partner was ill
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F6
Since becoming pregnant: A friend or relative was ill
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F7
Since becoming pregnant: You were admitted to hospital
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F8
Since becoming pregnant: You were in trouble with the law
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F9
Since becoming pregnant: You were divorced
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F10
Since becoming pregnant: You found that your partner didn't want your child
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F11
Since becoming pregnant: You were very ill
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen
F12
Since becoming pregnant: Your partner lost his job
1
Yes & affected me a lot
2
Yes, moderately affected
3
Yes, mildly affected
4
Yes, but did not affect me at all
5
No did not happen