Goossens J, Van Den Branden Y, Van der Sluys L, Delbaere I, Van Hecke A, Verhaeghe S, Beeckman D
University Centre for Nursing & Midwifery, Department of Public Health , Ghent University, De Pintelaan 185,9000 Ghent, Belgium
University Centre for Nursing & Midwifery, Department of Public Health , Ghent University, De Pintelaan 185,9000 Ghent, Belgium.
Hum Reprod. 2016 Dec;31(12):2821-2833. doi: 10.1093/humrep/dew266. Epub 2016 Oct 24.
What are associated factors of unplanned pregnancies ending in birth?
Pregnancies that were less planned were associated with women of lower socio-economic status (SES), an unhealthier lifestyle before and during the pregnancy, more stress, and less social support.
In Europe, the prevalence of unplanned pregnancy leading to birth varies. Unplanned pregnancy is more common among socially disadvantaged women, and associated with adverse pregnancy outcomes.
STUDY DESIGN, SIZE, DURATION: In a cross-sectional study, 517 women were recruited from May through September 2015.
PARTICIPANTS/MATERIALS, SETTING, METHODS: Women were recruited from six hospitals in Flanders, Belgium. Data from self-report and medical records were collected during the first 5 days postpartum. The validated London Measure of Unplanned Pregnancy was used to collect data regarding pregnancy planning. Data were analysed with Mann-Whitney U tests, Kruskal-Wallis tests, and multiple linear regression analysis.
The majority of the pregnancies (83%) ending in birth were planned, 15% were ambivalent, and 2% unplanned. Women who are multigravida (95% CI -0.30 to -0.02), less well educated (95% CI 0.07-0.85), single or having a non-cohabiting relationship (95% CI 0.01-2.53), having history of drug abuse (95% CI -2.07 to -0.35), and experiencing intimate partner violence (95% CI -3.82 to -1.59) tended to have a significantly higher risk of a less planned pregnancy. Less planned pregnancies were significantly associated with initially unwanted pregnancies (P < 0.001), no folic acid or vitamin use before pregnancy (P < 0.001), lower number of prenatal visits (P = 0.03), smoking during pregnancy (P < 0.001), more stress (P = 0.002), lower relationship satisfaction (P = 0.001), and less social support (P < 0.001). Less planned pregnancies were also significantly associated with hyperemesis (P < 0.001) and shorter duration of delivery (P = 0.03). No differences were found in neonatal outcomes.
LIMITATIONS, REASONS FOR CAUTION: The prevalence of unplanned pregnancies is probably underestimated due to overrepresentation of women with higher SES in this study. Women's emotions may have influenced the answer to certain questions. Owing to the cross-sectional design, no causal relationships could be established.
This study emphasizes the importance of targeting socially disadvantaged women in the prevention of unplanned pregnancies.
STUDY FUNDING/COMPETING INTERESTS: This study was funded by the Research Foundation - Flanders (FWO). The authors have no conflict of interests.
Not applicable.
以分娩告终的意外怀孕的相关因素有哪些？
计划不那么周全的怀孕与社会经济地位较低（SES）的女性、怀孕前及怀孕期间不健康的生活方式、更多压力以及更少的社会支持有关。
在欧洲，导致分娩的意外怀孕发生率各不相同。意外怀孕在社会弱势女性中更为常见，且与不良妊娠结局相关。
研究设计、规模、持续时间：在一项横断面研究中，于2015年5月至9月招募了517名女性。
参与者/材料、背景、方法：从比利时弗拉芒地区的六家医院招募女性。在产后的前5天收集自我报告和医疗记录中的数据。使用经过验证的伦敦意外怀孕量表收集有关怀孕计划的数据。数据采用曼-惠特尼U检验、克鲁斯卡尔-沃利斯检验和多元线性回归分析进行分析。
大多数以分娩告终的怀孕（83%）是有计划的，15%是矛盾的，2%是意外的。多胎妊娠的女性（95%CI -0.30至-0.02）、受教育程度较低的女性（95%CI 0.07 - 0.85）、单身或处于非同居关系的女性（95%CI 0.01 - 2.53）、有药物滥用史的女性（95%CI -2.07至-0.35）以及遭受亲密伴侣暴力的女性（95%CI -3.82至-1.59）发生计划不那么周全的怀孕的风险往往显著更高。计划不那么周全的怀孕与最初不想要的怀孕（P < 0.001）、怀孕前未使用叶酸或维生素（P < 0.001）、产前检查次数较少（P = 0.03）、怀孕期间吸烟（P < 0.001）、更多压力（P = 0.002）、较低的关系满意度（P = 0.001）以及更少的社会支持（P < 0.001）显著相关。计划不那么周全的怀孕还与妊娠剧吐（P < 0.001）和分娩持续时间较短（P = 0.03）显著相关。在新生儿结局方面未发现差异。
局限性、谨慎原因：由于本研究中社会经济地位较高的女性占比过高，意外怀孕的发生率可能被低估。女性的情绪可能影响了对某些问题的回答。由于采用横断面设计，无法建立因果关系。
本研究强调了针对社会弱势女性预防意外怀孕的重要性。
研究资金/利益冲突：本研究由弗拉芒研究基金会（FWO）资助。作者不存在利益冲突。
不适用。
