Cha Susan, Chapman Derek A, Wan Wen, Burton Candace W, Masho Saba W
Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA.
Division of Epidemiology, Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, VA.
Am J Obstet Gynecol. 2016 Apr;214(4):494.e1-494.e12. doi: 10.1016/j.ajog.2015.10.149. Epub 2015 Oct 28.
Rapid repeat pregnancy (RRP) is a major problem in the United States. Few studies have explored the influence of partner agreement on pregnancy intention and RRP.
We sought to examine the association between couple pregnancy intentions and RRP among women in the United States.
Data came from the 2006 through 2010 National Survey of Family Growth. Multiparous women who cohabited with 1 husband/partner before conception of second pregnancy were included (N = 3463). The outcome, RRP, was categorized as experiencing a second pregnancy within 24 months of the first pregnancy resolution, or ≥24 months from the first pregnancy resolution. Maternal and paternal pregnancy intentions were categorized into 4 dyads: both intended (M+P+); maternal intended and paternal unintended (M+P-); maternal unintended and paternal intended (M-P+); and both unintended (M-P-). Multiple logistic regression was conducted to determine the association between couple pregnancy intentions and RRP.
Nearly half (49.4%) of women had RRP. Approximately 15% of respondents reported discordant couple pregnancy intentions and 22%, maternal and paternal unintendedness. Compared to couples who both intended their pregnancy (M+P+), the odds of RRP was higher when fathers intended pregnancy but not mothers (adjusted odds ratio, 2.51; 95% confidence interval, 1.45-4.35) and lower if fathers did not intend pregnancy but mothers did (adjusted odds ratio, 0.77; 95% confidence interval, 0.70-0.85). No difference was observed between concordant couple pregnancy intentions (M-P- vs M+P+).
Findings highlight the important role of paternal intention in reproductive decisions. Study results suggest that RRP is strongly influenced by paternal rather than maternal pregnancy intentions. Clinicians and public health workers should involve partners in family planning discussions and counseling on optimal birth spacing.
快速再次怀孕（RRP）在美国是一个主要问题。很少有研究探讨伴侣意见一致对怀孕意愿和RRP的影响。
我们试图研究美国女性伴侣怀孕意愿与RRP之间的关联。
数据来自2006年至2010年全国家庭成长调查。纳入了在第二次怀孕前与1名丈夫/伴侣同居的经产妇（N = 3463）。RRP这一结果被分类为在第一次怀孕结束后24个月内经历第二次怀孕，或自第一次怀孕结束起≥24个月。孕产妇和父亲的怀孕意愿被分为4种二元组：双方都有意愿（M + P +）；母亲有意愿而父亲无意愿（M + P -）；母亲无意愿而父亲有意愿（M - P +）；以及双方都无意愿（M - P -）。进行多因素逻辑回归以确定伴侣怀孕意愿与RRP之间的关联。
近一半（49.4%）的女性经历了RRP。约15%的受访者报告伴侣怀孕意愿不一致，22%报告母亲和父亲都无怀孕意愿。与双方都有怀孕意愿的伴侣（M + P +）相比，当父亲有怀孕意愿而母亲没有时，RRP的几率更高（调整后的优势比为2.51；95%置信区间为1.45 - 4.35），而当父亲没有怀孕意愿但母亲有时，RRP的几率更低（调整后的优势比为0.77；95%置信区间为0.70 - 0.85）。在伴侣怀孕意愿一致的情况之间（M - P - 与M + P +）未观察到差异。
研究结果突出了父亲意愿在生育决策中的重要作用。研究结果表明，RRP受父亲而非母亲怀孕意愿的强烈影响。临床医生和公共卫生工作者应让伴侣参与计划生育讨论以及关于最佳生育间隔的咨询。
