Pregnancy Intention and Breastfeeding Behaviors in Virginia: A Secondary Analysis of PRAMS Data

Abstract

Background:Unintended pregnancy has been linked to adverse outcomes for the mother–baby dyad. The literature on the association between pregnancy intention and breastfeeding is inconsistent. This project aims to use pregnancy intention as a proxy for breastfeeding intention to determine the relationship between pregnancy intention and breastfeeding behaviors among postpartum women in Virginia.Methods:Participants were drawn from the Virginia Pregnancy Risk Assessment Monitoring System Phase 8 (2018–2019) dataset (N= 1,765). The population of interest was women who had recently given birth to a live infant during the surveillance year. Descriptive analyses were carried out, followed by bivariate analyses, to assess the correlation between pregnancy and breastfeeding initiation and duration. Multivariate logistic regressions were run to evaluate the probability of initiating breastfeeding and breastfeeding duration using pregnancy intention status.Results:Factors significantly associated with breastfeeding initiation were having a normal body mass index (BMI; OR 2.02; 95% CI: 1.08–3.77), being a nonsmoker (OR 4.17; 95% CI: 2.09–8.30), and being 30–34 years old (OR 6.22; 95% CI: 1.37–28.28). Pregnancy intention revealed a statistically significant correlation with breastfeeding initiation in the bivariate analysis (p< .001). Factors associated with breastfeeding longer than 12 weeks were having a low level of income (OR 1.65; 95% CI: 1.05–2.58), having a normal or overweight BMI (OR 1.84; 95% CI: 1.35–2.52; OR 1.56; 95% CI: 1.10–2.23), and being a nonsmoker (OR 2.91; 95% CI: 1.64–5.16). Although Chi-Square tests reported a statistically significant correlation with pregnancy intention and breastfeeding duration (p< .001), the relationship was no longer significant in the adjusted analysis (p> .2).Conclusion:Interventions to promote breastfeeding, especially among women with unintended pregnancies, are necessary to improve maternal and child health outcomes.