Kaiser Permanente, Division of Research, Northern California, 2000 Broadway, Oakland, CA 94612, USA.
Matern Child Health J. 2010 Mar;14(2):227-34. doi: 10.1007/s10995-009-0446-5. Epub 2009 Jan 19.
Published studies show poor pregnancy outcomes associated with unintended pregnancies are disproportionately higher than in planned pregnancies and place a burden on the health care system. This study was designed to compare pregnancy intention rates, compare sociodemographic characteristics of women by pregnancy intention and compare pregnancy outcomes in a managed care setting.
A large managed health care organization in California conducted a retrospective medical record review of 1,784 women seeking prenatal care in 2002 to learn how women self-reported their pregnancy intention, compare pregnancy intention rates between this health plan to the national data, and to compare antecedents and pregnancy outcomes based on pregnancy intention.
Overall, 62.1% of pregnancies were self-reported as intended with 26.4% mistimed and 11.4% unwanted. Being young, single, having lower educational attainment, having other living children, consuming alcohol and being a woman of color were the greatest predictors of having an unintended pregnancy. Despite these predictors, birth outcomes for unintended pregnancies in this setting showed no statistical difference from planned pregnancies.
Awareness of pregnancy intention of the women who are at greatest risk may be an important contributor to improving birth outcomes and health plan decisions about reproductive care services. Early entry to prenatal care and integrated services that decrease substance abuse and support high-risk pregnancy management are important contributors to reducing poor pregnancy outcomes.
已发表的研究表明，意外妊娠与计划妊娠相比，其妊娠结局较差的比例更高，这给医疗保健系统带来了负担。本研究旨在比较妊娠意向率，比较按妊娠意向划分的女性的社会人口学特征，并比较在管理式医疗保健环境中的妊娠结局。
加利福尼亚州的一家大型管理式医疗保健组织对 2002 年寻求产前护理的 1784 名女性进行了回顾性病历审查，以了解女性如何自我报告其妊娠意向，将本健康计划的妊娠意向率与全国数据进行比较，并根据妊娠意向比较妊娠前因和妊娠结局。
总体而言，62.1%的妊娠被自我报告为有意妊娠，26.4%的妊娠被报告为时机不当，11.4%的妊娠被报告为不想要。年轻、单身、受教育程度较低、有其他子女、饮酒以及有色人种的女性是意外妊娠的最大预测因素。尽管存在这些预测因素，但在这种情况下，意外妊娠的分娩结局与计划妊娠无统计学差异。
了解处于高风险的女性的妊娠意向可能是改善分娩结局和医疗保健计划关于生殖保健服务决策的重要因素。尽早进入产前保健和提供综合服务，减少物质滥用并支持高危妊娠管理，是减少不良妊娠结局的重要因素。
