Factors associated with unintended pregnancy in Brazil: cross-sectional results from the Birth in Brazil National Survey, 2011/2012

Abstract

BackgroundUnintended pregnancy, a pregnancy that have been either unwanted or mistimed, is a serious public health issue in Brazil. It is reported for more than half of women who gave birth in the country, but the characteristics of women who conceive unintentionally are rarely documented. The aim of this study is to analyse the prevalence and the association between unintended pregnancy and a set of sociodemographic characteristics, individual-level variables and history of obstetric outcomes.MethodsBirth in Brazil is a cross-sectional study with countrywide representation that interviewed 23,894 women after birth. The information about intendedness of pregnancy was obtained after birth at the hospital and classified into three categories: intended, mistimed or unwanted. Multinomial regression analysis was used to estimate the associations between intendedness of a pregnancy, and sociodemographic and obstetric variables, calculating odds ratios and 95 % confidence intervals. All significant variables in the bivariate analysis were included in the multinomial multivariate model and the final model retaining variables that remained significant at the 5 % level.ResultsUnintended pregnancy was reported by 55.4 % of postpartum women. The following variables maintained positive and significant statistical associations with mistimed pregnancy: maternal age < 20 years (OR = 1.89, 95 % CI: 1.68–2.14); brown (OR = 1.15, 95 % CI: 1.04–1.27) or yellow skin color (OR = 1.56, 95 % CI: 1.05–2.32); having no partner (OR = 2.32, 95 % CI: 1.99–2.71); having no paid job (OR = 1.15, 95 % CI: 1.04–1.27); alcohol abuse with risk of alcoholism (OR = 1.25, 95 % CI: 1.04–1.50) and having had three or more births (OR = 2.01, 95 % CI: 1.63–2.47). The same factors were associated with unwanted pregnancy, though the strength of the associations was generally stronger. Women with three or more births were 14 times more likely to have an unwanted pregnancy, and complication in the previous pregnancies and preterm birth were 40 % and 19 % higher, respectively. Previous neonatal death was a protective factor for both mistimed (OR = 0.61, 95 % CI: 0.44–0.85) and unwanted pregnancy (OR = 0.44, 95 % CI: 0.34–0.57).ConclusionsThis study confirms findings from previous research about the influence of socioeconomic and individual risk factors on unintended pregnancy. It takes a new approach to the problem by showing the importance of previous neonatal death, preterm birth and complication during pregnancy as risk factors for unintended pregnancy.Electronic supplementary materialThe online version of this article (doi:10.1186/s12978-016-0227-8) contains supplementary material, which is available to authorized users.

Women's Reproductive Intentions and Behaviors during the Zika Epidemic in Brazil

“…Moreover, because women with lower socioeconomic status not only have higher rates of unintended pregnancy (Theme‐Filha et al. ), but also higher rates of mosquito‐borne illnesses (Almeida, Medronho, and Valencia ; Siqueira et al. ) and STIs (Szwarcwald et al.…”

“…; Theme‐Filha et al. ), women with greater economic resources may be more successful in preventing unwanted pregnancy during the epidemic and beyond.…”

“…These abortions may pose additional health risks because many are unsafe (Fusco and Andreoni 2012;Grimes et al 2006), and they may be especially risky if performed in the second or third trimester. Because unintended pregnancy disproportionately occurs among women of lower socioeconomic status (Prietsch et al 2011;Theme-Filha et al 2016), women with greater economic resources may be more successful in preventing unwanted pregnancy during the epidemic and beyond.…”

Childhood abuse and unplanned pregnancies: a cross‐sectional study of women in the Norwegian Mother and Child Cohort Study

“…In addition, unplanned pregnancies preclude health‐promoting behaviours before conception and in early pregnancy. Young maternal age, high parity, ethnicity, alcohol abuse and low educational levels are associated with increased risk of having an unintended pregnancy …”

“…Young maternal age, high parity, ethnicity, alcohol abuse and low educational levels are associated with increased risk of having an unintended pregnancy. 4,5 Childhood abuse has previously been suggested to have long-term effects that continue into adulthood with repercussions on the psychosocial situation and health, including family life and reproductive health. [6][7][8] Women exposed to childhood emotional, physical and/or sexual abuse have more sexually risk-taking behaviours than non-exposed women.…”