Preconception health behaviors associated with pregnancy planning status among Brazilian women

Borges, Ana Luiza Vilela; Santos, Osmara Alves dos; Nascimento, Natália de Castro; Chofakian, Christiane Borges do Nascimento; Gomes-Sponholz, Flávia Azevedo

doi:10.1590/S0080-623420160000200005

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ORIGINAL ARTICLE • REEUSPRev. esc. enferm. USP 50 (02) • Mar-Apr 2016 • https://doi.org/10.1590/S0080-623420160000200005 copy

Preconception health behaviors associated with pregnancy planning status among Brazilian women

Preparación pre concepcional entre mujeres brasileñas y la relación con la planificación del embarazo

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

OBJECTIVE

The objective of this study is to assess preconception health behaviors among Brazilian women, and analyze the effect of pregnancy planning status in carrying out preconception measures.

METHOD

This is a cross-sectional quantitative study conducted with 807 women, of whom 649 had a planned or ambivalent pregnancy. Preconception health behaviors were assessed by the Brazilian version of the London Measure of Unplanned Pregnancy.

RESULTS

Preconception health behaviors were performed by only 15.9% of women. Among those who planned their pregnancy, less than half completed a health measure (47.0%); the most common was seeking medical assistance and improving the diet. Multiple logistic regression analysis showed a strong association between the preconception health behaviors and a planned pregnancy (adjusted OR = 16.77; 95% CI: 9.47-29.81). Age over 30 years, paid work, and the time interval between menarche and first sexual intercourse were also associated with completing preconception measures

CONCLUSION

The low frequency of preconception health measures, even among women who planned their pregnancy, indicates the urgency of including preconception care on the agenda of public health policies in Brazil.

Descriptors:
Preconception Care; Pregnancy; Sexual and Reproductive Health; Maternal-Child Nursing

Variables	Preconception health behavior
	No		Yes		Total		p^* * Chi-square test;
	n	%	n	%	N	%
Pregnancy planning status
Ambivalent	405	77.7	25	19.5	430	66.3	<0.001
Planned	116	22.3	103	80.5	219	33.7
Age (in years)
13-19	160	30.7	24	18.8	184	28.4	<0.001
20-25	146	28.0	26	20.3	172	26.5
26-30	101	19.4	27	21.1	128	19.7
31 and over	114	21.9	51	39.8	165	25.4
Lives with partner
No	101	19.4	16	12.5	117	18.0	0.069
Yes	420	80.6	112	87.5	532	82.0
Paid job
No	277	53.2	46	35.9	323	49.8	<0.001
Yes	244	46.8	82	64.1	326	50.2
Race/ethnicity
White	350	67.2	79	61.7	429	66.1	0.242
Non-white	171	32.8	49	38.3	220	33.9
Number of pregnancies
One	244	46.8	60	46.9	304	46.8	0.981
Two	143	27.5	36	28.1	179	27.6
Three or more	134	25.7	32	25.0	166	25.6
Previous abortion
No	335	64.3	81	63.3	416	64.1	0.830
Yes	186	35.7	47	36.7	233	35.9
Total	521	100.0	128	100.0	649	100.0
	Mean	sd^ sd: standard deviation;	Mean	sd	Mean	sd	p^* ***** Mann-Whitney test;
Schooling (years)	9.5	2.4	10.0	2.4	9.6	2.4	0.026
Interval 1^** ****** Time interval between menarche and first sexual intercourse (in years);	3.6	2.5	4.8	3.2	3.8	2.7	<0.001
Interval 2^*** *** Time interval between the age at first sexual intercourse and at first pregnancy (in years)	3.8	3.7	4.9	4.4	4.0	3.8	0.017

Preconception health behaviors	All women^* * Includes women with unplanned pregnancies; ( n = 807)		Women with planned pregnancy ( n = 219)		Women with ambivalent pregnancy ( n = 430)
	n	%	n	%	n	%
One measure	62	7.7	43	19.6	19	4.4
Two or more measures	66	8.2	60	27.4	6	1.4
Types of measures^ Question admitted multiple answers;
Sought medical assistance	72	8.9	63	28.8	9	2.1
Started eating healthier	55	6.8	47	21.5	8	1.9
Took folic acid	45	5.6	40	18.3	5	1.2
Stopped/reduced alcoholic drinking	17	2.1	12	5.5	5	1.2
Stopped/reduced smoking	15	1.8	13	5.9	2	0.5
Other actions^* ***** Financial planning for pregnancy, avoiding situations of stress, getting better sleep, engaging in physical activities, avoiding drug use, controlling preexisting conditions, undergoing pregestational examinations, and infertility treatment	34	4.2	31	14.1	3	0.7

Variables	Model 1		Model 2		Model 3
Variables	Adj OR	CI 95%	Adj OR	CI 95%	Adj OR	CI 95%
Pregnancy planning status
Ambivalent Planned	1.00 16.77	- 9.45-29.76
Age (in years)
13-19 20-25 26-30 31 or more	1.00 0.56 0.67 0.94	- 0.25-1.26 0.25-1.83 0.32-2.72	1.00 0.95 1.41 2.57	- 0.47-1.92 0.60-3.28 1.03-6.39	1.00 1.62 1.70 2.28	- 0.52-5.06 0.44-6.48 0.56-9.34
Schooling (in years)	1.08	0.97-1.20	1.03	0.94-1.13	1.11	0.98-1.26
Lives with partner
No Yes	1.00 0.58	- 0.28-1.19	1.00 1.37	- 0.75-2.51	1.00 0.40	- 0.11-1.45
Paid job
No Yes	1.00 1.38	- 0.82-2.33	1.00 1.60	- 1.02-2.51	1.00 1.18	- 0.63-2.21
Race/ethnicity
Non-white White	1.00 0.84	- 0.52-1.37	1.00 1.07	- 0.70-1.65	1.00 0.93	- 0.52-1.65
Number of pregnancies
One Two Three or more	1.00 0.90 0.83	- 0.46-1.78 0.35-1.95	1.00 0.74 0.56	- 0.41-1.35 0.27-1.20	1.00 0.80 0.88	- 0.36-1.81 0.32-2.43
Interval 1^* * Time interval between menarche and first sexual intercourse (in years);	1.07	0.98-1.17	1.10	1.02-1.19	1.05	0.95-1.15
Interval 2^ Time interval between the age at first sexual intercourse and at first pregnancy (in years). Model 1: considers the effect of pregnancy planning; Model 2: does not consider the effect of pregnancy planning; Model 3: considers only women with planned pregnancies. Hosmer-Lemeshow test: Model 1 = 0.83; Model 2 = 0.41; Model 3 = 0.25.	0.98	0.90-1.05	1.00	0.93-1.06	0.97	0.89-1.06

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Ana Luiza Vilela Borges. Departamento de Enfermagem em Saúde Coletiva/EEUSP. Av. Dr. Enéas de Carvalho Aguiar, 419 - Cerqueira César. CEP 05403-000 - São Paulo, São Paulo, Brazil. alvilela@usp.br