Prevalence and factors associated with unplanned pregnancy in a Brazilian capital in the Northeast

Costa, Ana Cleide Mineu; Oliveira, Bruno Luciano Carneiro Alves de; Alves, Maria Teresa Seabra Soares de Britto e

doi:10.1590/1806-93042021000200007

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Revista Brasileira de Saúde Materno Infantil

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ORIGINAL ARTICLES • Instituto de Medicina Integral Prof. Fernando Figueira 21 (2) • Apr-Jun 2021 • https://doi.org/10.1590/1806-93042021000200007 copy

Prevalence and factors associated with unplanned pregnancy in a Brazilian capital in the Northeast

Authorship SCIMAGO INSTITUTIONS RANKINGS

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

Key words:
Unplanned pregnancy; Reproductive planning; Reproductive health; Inequalitiess

	Planned pregnancy				General Total		p ^# # Pearson's chi-square test;
	Yes		No
	n	%	n	%	n	%
Total	1.630	31.9	3.480	68.1	5.110	100.0
Skin color^* * except if ignored,							0.001
White	337	36.1	597	63.9	934	18.0
Mixed	1.118	31.9	2.391	68.1	3.509	69.0
Black	171	26.1	484	73.9	655	13.0
Age group (years)							0.001
Upto 19	201	21.1	750	78.9	951	19.0
20 - 24	488	29.8	1.147	70.2	1.635	32.0
25 - 29	460	34.4	878	65.6	1.338	26.0
30 or more	479	40.7	699	59.3	1.178	23.0
Live with partner							0.001
Yes	1.470	35.8	2.637	64.2	4.107	80.5
No	158	15.9	837	84.1	995	19.5
Schooling (years)^* * except if ignored,							0.001
12 or more	337	44.1	427	55.9	764	15.0
9 - 11	926	31.4	2.026	68.6	2.952	58.0
5 - 8	295	26.0	843	74.0	1.138	22.0
0 - 4	66	28.2	168	71.8	234	5.0
Income (minimum wage)^ Minimum Wage R$ 510,00.							0.001
>5	316	42.8	423	57.2	739	17.6
More than 3 - 5	129	29.3	311	70.7	440	10.5
1 - 3	729	30.7	1.645	69.3	2.374	57.8
<1	209	33.1	421	66.9	630	15.1
Economic class^* * except if ignored,							0.001
A/B	392	42.7	526	57.3	918	19.2
C	812	31.5	1.769	68.5	2.581	53.8
D/E	355	27.4	943	72.6	1.298	27.0
People in the household							0.001
1 - 2 people	554	43.4	723	56.6	1.277	25.0
3 - 4 people	686	30.8	1.542	69.2	2.228	43.7
>5 people	388	24.3	1.209	75.7	1.597	31.3
Partner's age (years)							0.003
Upto 19	22	21.8	79	78.2	101	2.0
20 - 24	247	31.3	542	68.7	789	15.4
25 - 29	358	36.2	632	63.8	990	19.4
30 or more	1.001	31.0	2.221	69.0	3.222	63.2
Partner's schooling (years)							0.001
12 or more	312	43.5	405	56.5	717	15.4
9 or 11	886	33.8	1.738	66.2	2.624	56.2
5 or 8	245	26.0	698	74.0	943	20.2
0 or 4	101	26.3	283	73.7	384	8.2

		Planned pregnancy			General Total		p ^# # Pearson's chi-square test;
	Yes		No
	n	%	n	%	n	%
Smoking habit							0.001
No	1,506	32.6	3.106	67.4	4,612	90.4
Yes	122	25.0	366	75.0	488	9.6
Drinking habit							0.001
No	1,450	33.3	2.909	66.7	4,359	85.4
Yes	178	24.0	565	76.0	743	14.6
Number of children^* * except ignored.							0.001
First	865	34.3	1.659	65.7	2,524	49.8
2 or 3	656	30.5	1.498	69.5	2,154	42.5
4 or more	85	22.0	302	78.0	387	7.7
Previous abortion							0.001
No	1,204	30.0	2.791	70.0	3,995	78.3
Yes	424	38.3	683	61.7	1,107	21.7
Previous stillbirth							0.533
No	1,556	31.8	3.353	68.2	4,919	96.4
Yes	62	33.9	121	66.1	183	3.6
Previous premature birth^* * except ignored.							0.859
No	1,362	31.9	2.949	68.1	4,331	85.2
Yes	241	31.9	514	68.1	755	14.8
Pre-pregnancy BMI							0.001
Malnourished	128	25.8	369	74.2	497	9.7
Eutrophic	802	34.4	1.531	65.2	2,333	45.7
Overweight	243	38.7	385	61.3	628	12.3
Obese	455	27.7	1.189	72.3	1,644	32.3

	Unplanned pregnancy		P+R	CI95%	p ^# # Pearson's chi-square test;
	N	%	P+R	CI95%	p ^# # Pearson's chi-square test;
Distal Level
Skin color^## ## except ignored,					0.001
White	587	63.9	Ref.
Black	494	73.9	1.03	1.01 - 1.07
Mixed	2,391	68.1	0.99	0.97 - 1.01
Age(years)^## ## except ignored,					<0.001
30 or more	699	59.3	Ref.
25 - 29	874	65.6	1.02	0.99 - 1.04
20 - 24	1,147	70.2	1.04	1.01 - 1.07
Upto 19	750	78.8	1.09	1.06 - 1.12
Live with partner					<0.001
Yes	2,637	64.2	Ref.
No	837	84.1	1.09	1.07 - 1.11
Distal Level
Schooling in years^## ## except ignored,					0.770
12 or more	427	55.9	Ref.
9 - 11	2,026	68.6	1.01	0.98-1.04
5 - 8	843	74.6	1.01	0.98-1.05
0 - 4	168	71.8	1.01	0.96-1.07
Income in minimum wages^* * Minimum Wage R$ 510.00. ^## ## except ignored,					0.373
5 or more	423	57.2	Ref.
>3 to 5	311	70.7	1.02	0.98-1.05
1 to 3	1,645	69.3	1.02	0.98-1.05
<1	421	66.9	1.00	0.95-1.04
Class by assets ownership^## ## except ignored,					0.075
A/B	526	57.3	Ref.
C	1,769	68.5	1.02	0.99-1.05
D/E	943	72.6	1.04	1.01-1.08
People in the household^## ## except ignored,					<0.001
1 - 2 people	723	56.6	Ref.
3 - 4 people	1,522	69.2	1.08	1.05-1.10
More than 5 people	1,209	75.7	1.10	1.08-1.13
Intermediate Level
Smoking habit					0.148
No	3,106	67.4	Ref.
Yes	366	78.0	1.01	0.99-1.04
Drinking habit					0.005
No	2,909	66.7	Ref.
Yes	565	76.0	1.03	1.01-1.05
Number of children^## ## except ignored,					<0.001
First	1,559	65.7	Ref.
2 or 3	1,498	69.5	1.03	1.02-1.05
4 or more	302	78.0	1.09	1.06-1.13
Previous abortion					<0.001
No	2,791	70.0	Ref.
Yes	683		61.7	0.95	0.93-0.97
Previous premature birth^## ## except ignored,					0.555
No	2,949	68.1	Ref.
Yes	514	68.1	0.99	0.97-1.01
Previous stillbirth^## ## except ignored,					0.656
No	121	66.1	Ref.
Yes	3,353	68.2	0.99	0.94-1.03
Pre-pregnancy BMI					0.033
Eutrophic	1,531	65.6	Ref.
Malnourished	369	74.2	1.03	1.01-1.06
Overweight	385	61.3	0.98	0.96-1.01
Obesity	1,189	72.3	1.00	0.99-1.02
Proximal Level
Partner's age (in years)					0.185
30 or more	2,221	69.0	Ref.
25 - 29	632	63.8	0.99	0.96-1.01
20 - 24	542	68.7	0.99	0.97-1.02
Up to19	79	78.2	1.04	0.99-1.10
Partner's education (in years)					0.045
12 or more	405	56.5	Ref.
9 - 11	1,738	66.2	1.01	0.99-1.04
5 - 8	698	74.0	1.03	1.01-1.07
0 - 4	283	73.7	0.99	0.95-1.03

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[1] Authors' contribution

Costa ACM and Alves MTSSB participated equally in the study design, data analysis, interpretation of the results, writing of the manuscript. Oliveira BLCA participated in the discussion of the results, writing and critical revision of the paper. All authors approved the final version of the article.