Abstract
Abstract Objectives: to analyze the prevalence and factors associated with unplanned pregnancy in a Brazilian capital in the Northeast. Methods: a cross-sectional study nested to a hospital birth cohort with a probable sample of 5,110 puerperal women. Associated factors were analyzed using a hierarchical theoretical model in three levels: distal (women’s socioeconomic and demographic characteristics), intermediate (reproductive characteristics, maternal habits and BMI), and proximal level (partner's characteristics). Multivariate Poisson regression analysis was performed. Results: the prevalence of unplanned pregnancy was 68.1% (CI95%=66.8-69.4). Multivariate analysis showed association with black skin color/race (PR=1.03; CI95%=1.01- 1.07), mother's age group up to 19 years old (PR=1.09; CI95%=1.06-1.12) and 20 to 24 years old (PR=1.04; CI95%=1.01-1.07), not living with partner (PR=1.09; CI95%=1.07- 1.11), highest number of people in the household: 5 people (PR= 1.10; CI95%=1.08-1.13) and 3 to 4 (PR=1.08; CI95%=1.05-1.10), number of ≥4 children (PR=1.09; CI95%=1.06- 1.13) and 2 or 3 children (PR=1.03; CI95%=1.02-1.05), alcohol consumption (PR=1.03; CI95%=1.01-1.05), malnourished pre-pregnancy BMI (PR=1.03; CI95%=1.01-1.06) and partner’s low schooling (5 to 8 years) (PR=1.03; CI95%=1.01-1.07). Prior abortion was inversely associated with planned pregnancy (PR=0.95; CI95%=0.93-0.97). Conclusions: the prevalence of unplanned pregnancy was high and was associated with socioeconomic and demographic characteristics that reflect on the combination of the complex inequalities that impact women and their partners
Highlights
The majority (56.2%) reported the partner's schooling level of 9 to 11 years, with an age of over 30 years (63.2%). Among those who did not plan a pregnancy, 78.3% were under 19 years old, 73.9% reported being black race/color, 84.1% did not live with their partner, 74.0% had 5 to 8 years of schooling, 70.7% had a family income of less than 1 minimum wage, 72.6% belonged to D and E economic class, 75.7% reported having more than five people in the household, 78.2% had a partner aged up to 19 years old and 74.0% had 5 to 8 years of schooling (Table 1)
Of those who did not plan a pregnancy, 75.0% had the habit of smoking, 76.0% reported alcohol consumption, 78.0% had 4 or more children, 61.7% had a previous abortion, 66.1% had a previous stillborn, 74.2% had a previous premature delivery, and 74% were classified as pre-pregnancy Body Mass Index (BMI) on malnutrition (Table 2)
The results of this study indicated a high prevalence of unplanned pregnancy among puerperal women who participated in this cross-sectional study nested to a hospital birth cohort
Summary
Unplanned, unwanted, or unintended pregnancy by one or both partners is a public health indicator key and is the leading global reproductive health problem, causing significant physical, economic, social and psycho-emotional problems[1-4] that negatively impact women, partners and children involved, both in current and future life cycles.[2]Global, regional, and sub-regional estimates of unplanned pregnancy show that there has been a reduction in these estimates from 1995 to 20083 and from 1990-1994 to 2010-2014.4 But the worst estimates remain in developing countries, especially in the African continent.[3,4] In some cases, the estimates have even grown as in the South American and Caribbean sub-regions.[3,4] In 2008 alone, 208 million pregnancies were estimated, 185 million of which occurred in developing countries and 11.3 million in South America, of which 63.0% were unplanned.[3]. Regional, and sub-regional estimates of unplanned pregnancy show that there has been a reduction in these estimates from 1995 to 20083 and from 1990-1994 to 2010-2014.4 But the worst estimates remain in developing countries, especially in the African continent.[3,4]. In 2008 alone, 208 million pregnancies were estimated, 185 million of which occurred in developing countries and 11.3 million in South America, of which 63.0% were unplanned.[3]. 86 million pregnancies were unplanned, of which 33 million resulted in births and 41 million in abortions, half of the abortions occurred in unsafe situations and 98% were performed in developing countries.[3,4]. Between 2010 to 2014 there were about 99.1 million unplanned pregnancies per year, 23% of them resulted in unintended births and 56% in abortions during this period. In South America, there were 72.0% of unplanned pregnancies.[4]
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