Abstract
BackgroundThere has been considerable debate in the reproductive health literature as to whether unintended pregnancy influences use of maternal health services, particularly antenatal care. Despite the wealth of studies examining the association between pregnancy intention and antenatal care, findings remain mixed and inconclusive. The objective of this study is to systematically review and meta-analyse studies on the association between pregnancy intention and antenatal care.MethodsWe reviewed studies reporting on pregnancy intention and antenatal care from PubMed, Popline, CINHAL and Jstor search engines by developing search strategies. Study quality was assessed for biases in selection, definition of exposure and outcome variables, confounder adjustment, and type of analyses. Adjusted odds ratios, standard errors and sample size were extracted from the included studies and meta-analyzed using STATA version 11. Heterogeneity among studies was assessed using Q test statistic. Effect-size was measured by Odds ratio. Pooled odds ratio for the effects of unintended pregnancy on the use of antenatal care services were calculated using the random effects model.ResultsOur results indicate increased odds of delayed antenatal care use among women with unintended pregnancies (OR 1.42 with 95% CI, 1.27, 1.59) as compared to women with intended pregnancies. Sub-group analysis for developed (1.50 with 95% CI, 1.34, 1.68) and developing (1. 36 with 95% CI, 1.13, 1.65) countries showed significant associations. Moreover, there is an increased odds of inadequate antenatal care use among women with unintended pregnancies as compared to women with intended pregnancies (OR 1.64, 95% CI: 1.47, 1.82). Subgroup analysis for developed (OR, 1.86; 95% CI: 1.62, 2.14) and developing (OR, 1.54; 95% CI: 1.33, 1.77) countries also showed a statistically significant association. However, there were heterogeneities in the studies included in this analysis.ConclusionUnintended pregnancy is associated with late initiation and inadequate use of antenatal care services. Hence, women who report an unintended pregnancy should be targeted for antenatal care counseling and services to prevent adverse maternal and perinatal outcomes. Moreover, providing information on the importance of planning and healthy timing of pregnancies, and the means to do so, to all women of reproductive ages is essential.
Highlights
Maternal health care is important for better maternal, Perinatal and infant health outcomes
A number of studies have assessed the relationship between antenatal care and pregnancy intention finding that women with unintended pregnancies initiate antenatal care late and make inadequate antenatal care visits [12,13,14,15,16]
One hundred fifty (150) articles related to pregnancy intention and maternal health care were identified on the basis of the title but 87 were excluded because of duplication, due to lack of access, and because relevant aspects of pregnancy intention and outcome were not reported
Summary
Maternal health care is important for better maternal, Perinatal and infant health outcomes. Delayed entry into antenatal care may result in missed opportunities to diagnose pregnancy induced hypertension, gestational diabetes, or sexually transmitted infections. Use of these maternal health services is limited, especially in developing countries with high maternal and child mortality. Inconsistent findings have been reported in other studies concerning the association between pregnancy intention and antenatal care utilization [17,18,19,20]. The fact that under-utilization of modern health services are major reasons for poor health in many developing countries of the world, the objective of this study is to systematically review and metaanalyse studies on the association between pregnancy intention and antenatal care. The objective of this study is to systematically review and meta-analyse studies on the association between pregnancy intention and antenatal care
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