Trends and inequalities in unplanned pregnancy in three population-based birth cohorts in Pelotas, Brazil

Abstract

Objectives To assess time trends in unplanned pregnancy, stratified by sociodemographic status, reproductive history, and inequalities in family income and women's skin color, in Pelotas, Brazil. Methods Data from mothers of participants of the 1993 (N = 5264), 2004 (N = 4243), and 2015 (N = 4268) Pelotas birth cohorts were analyzed. Unplanned pregnancy was investigated in the perinatal period, with tests to assess changes over time among different sociodemographic and reproductive history subgroups and inequalities as a function of family income and skin color. Results The prevalence of unplanned pregnancy was 62.7% (3299/ 5264), 65.9% (2794/ 4243), and 52.2% (2226/ 4268) in the 1993, 2004, and 2015 cohorts, respectively. Black or brown women and women of lower socioeconomic status had a higher prevalence of unplanned pregnancy in all cohorts. The overall rate of unplanned pregnancy decreased over time in most subgroups. Inequality as a function of family income and skin color increased during the time frame of assessment. Conclusions The prevalence of unplanned pregnancies decreased in the period analyzed, but it is still unjustifiably high. Efforts aimed at reducing unplanned pregnancy are vital and will require special attention to the most vulnerable groups.

Gravidez não planejada no Brasil: estudo nacional em oito hospitais universitários

“…There was a prevalence of 63% and 66% of UP in the first two periods, falling to 52% in 2015. The change coincided with the record of a lower proportion of families earning less than the minimum wage, a higher proportion of mothers working outside the home, higher maternal educational level and lower proportion of women with two or more children, in addition to a reduction in teenage pregnancy and a higher proportion of mothers aged 30 years or older 13 .…”

“…The only Brazilian study that we are aware of that carried out a longitudinal comparison took place in the municipality of Pelotas, in the southern region, and evaluated the prevalence of UP in 1993, 2004 and 2015 13 . There was a prevalence of 63% and 66% of UP in the first two periods, falling to 52% in 2015.…”

Cohort Profile Update: 2015 Pelotas (Brazil) Birth Cohort Study－follow-ups from 2 to 6–7 years, with COVID-19 impact assessment

“…The prevalence of unplanned pregnancies decreased between the 1993 and 2015 cohorts but remained high (52.2% in 2015) 8 ; the prevalence of unmet need for modern contraceptives was 10.7% in the 2015 cohort. 9 Both inadequate and excessive gestational weight gain in pregnancy were common: 30.6% and 35.9%, respectively.…”

Opioid exposure during pregnancy and the risk of congenital malformation: a meta-analysis of cohort studies

“…On the other hand, increasing opioid use among reproductive-age women has also been widespread [ 9 , 10 ]. Since unplanned pregnancies are not uncommon and many pregnancies are not recognized until a few weeks after conception [ 11 ], all women prescribed opioid at reproductive age were at potential risk [ 12 ].…”