Abstract

BackgroundEstimates of unplanned pregnancy worldwide are of concern, especially in low and middle-income countries, including Brazil. Although the contraceptive prevalence rate is high in Brazil, almost half of all pregnancies are reported as unintended. The only source of nationally representative data about pregnancy intention is the Demographic and Health Survey, as with many other countries. In more recent years, however, it has been realized that concept of unintended pregnancy is potentially more complex and requires more sophisticated measurement strategies, such as the London Measure of Unplanned Pregnancy (LMUP). The LMUP has been translated and validated in other languages, but not Portuguese yet. In this study, we evaluate the psychometric properties of the LMUP in the Portuguese language, Brazilian version.MethodsA Brazilian Portuguese version of the LMUP was produced via translation and back-translation. After piloting, the mode of administration was changed from self-completion to interviewer-administration. The measure was field tested with pregnant, postpartum, and postabortion women recruited at maternity and primary health care services in Sao Paulo city. Reliability (internal consistency) was assessed using Cronbach’s alpha and item-total correlations. Construct validity was assessed using principal components analysis and hypothesis testing. Scaling was assessed with Mokken analysis.Results759 women aged 15–44 completed the Brazilian Portuguese LMUP. There were no missing data. The measure was acceptable and well targeted. Reliability testing demonstrated good internal consistency (alpha = 0.81, all item-rest correlations >0.2). Validity testing confirmed that the measure was unidimensional and that all hypotheses were met: there were lower LMUP median scores among women in the extreme age groups (p < 0.001), among non-married women (p < 0.001) and those with lower educational attainment (p < 0.001). The Loevinger H coefficient was 0.60, indicating a strong scale.ConclusionThe Brazilian Portuguese LMUP is a valid and reliable measure of pregnancy planning/intention that is now available for use in Brazil. It represents a useful addition to the public health research and surveillance toolkit in Brazil.

Highlights

  • Estimates of unplanned pregnancy worldwide are of concern, especially in low and middle-income countries, including Brazil

  • As existing measures developed in specific contexts need to be evaluated before use in new ones [21] and because there are differences across populations in terms of contraceptive practice, gender relations and pregnancy expectations, our aim was to validate the London Measure of Unplanned Pregnancy (LMUP) for the Portuguese language, Brazilian version, and to evaluate its psychometric properties

  • We found the full range of LMUP scores (Fig. 1)

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Summary

Introduction

Estimates of unplanned pregnancy worldwide are of concern, especially in low and middle-income countries, including Brazil. The contraceptive prevalence rate is high in Brazil, almost half of all pregnancies are reported as unintended. The only source of nationally representative data about pregnancy intention is the Demographic and Health Survey, as with many other countries. We evaluate the psychometric properties of the LMUP in the Portuguese language, Brazilian version. Even considering the differences in measurement scales and populations, estimates of unplanned pregnancy worldwide are of concern [1,2,3]. In 2006 the Demographic and Health Survey (DHS) in Brazil showed a high contraceptive prevalence rate (80.6 % among married women) coexisting with almost half of all pregnancies being reported as unwanted or mistimed (47.5 %) [4]. The answers are categorized as “intended”, “mistimed” and “unwanted”, with “mistimed” and “unwanted” being combined to form estimates of unintended pregnancy

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