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The Effect of Unintended Pregnancy and Time of Pregnancy Recognition on Birth Outcomes

Thursday, 16 July 2009: 9:10 AM

Adejoke B. Ayoola, PhD, RN
Nursing, Calvin College, Grand Rapids, MI
Laura R. Kapitula
Mathematics and Statistics, Calvin College, Grand Rapids, MI

Learning Objective 1: State whether the effect of the time of pregnancy recognition on birth outcomes is independent of unintended pregnancy.

Learning Objective 2: Describe the effect of unintended pregnancy and time of pregnancy recognition on birth outcomes.

Purpose: Reducing infant mortality is a significant global problem that attracted high priority in the Millennium Declaration. Unintended pregnancy increases the risk of adverse outcomes including preterm births and low birth weight (LBW) which have been associated with increased infant mortality. Delayed pregnancy recognition among women with unintended pregnancy could be a strong predictor of this increased adverse birth outcomes. This study examined the extent to which time of pregnancy recognition and unintended pregnancy independently predict adverse birth outcomes such as preterm birth, LBW and admission into neonatal intensive care unit (NICU).

Methods: Secondary data analysis was conducted using the Pregnancy Risk Assessment and Monitoring System (PRAMS) multi-state data for United States from 2000 to 2004. The PRAMS annual cross-sectional surveys, address maternal behaviors and experiences that occur before, during, and shortly after pregnancy among U.S. women of childbearing age. The analysis involved weighting of complex survey data using STATA10. Bivariate and multivariate statistics including contingency tables and logistic regressions were used.

Results: The study consisted of 143,303 women with age range of 11 to 53 years, 66.6% were married, and over 40% were having their first births. About 42.4% of the women described their pregnancies as unintended and 71.6% recognized their pregnancies early. There is significant interaction between the time of pregnancy recognition and women’s pregnancy intention. Among women with unintended pregnancy, those who recognized their pregnancy early have lower odds of having LBW (OR=0.86, p < 0.001), preterm births (OR=0.84, p < 0.001) and NICU admission (OR=0.82, p < 0.001) than women who recognized their pregnancy late.

Conclusion: The time of pregnancy recognition and women’s pregnancy intention are not independent of each other. Nursing interventions to promote early pregnancy recognition among women with unintended pregnancy may provide significant opportunities for reducing adverse birth outcomes and eventual infant mortality.

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