UNC Charlotte, Department of Public Health Sciences, Charlotte, NC.
UNC Charlotte, Department of Public Health Sciences, Charlotte, NC.
Ann Epidemiol. 2018 Jun;28(6):372-376. doi: 10.1016/j.annepidem.2018.03.012. Epub 2018 Mar 29.
One-third of all pregnancies in the United States are conceived within 18 months of a prior live birth. Preventing unintended pregnancies may help to decrease the prevalence of pregnancies with these short interpregnancy intervals. However, data on factors associated with pregnancy intention among women who have had short birth intervals are sparse. Pregnancy Risk Assessment Monitoring System data were used to further evaluate these associations.
Because only Mississippi and Tennessee Pregnancy Risk Assessment Monitoring System include a survey question about birth interval length, this analysis was limited to women from those states who recently had a short birth interval (n = 384). Pregnancy intention and demographic, lifestyle, and reproductive data were obtained from surveys and birth certificates. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs).
Nearly 76% of women with short birth intervals reported their pregnancy as unintended. Women who were non-Hispanic black or consumed alcohol during pregnancy had statistically significant increased odds of reporting the pregnancy with a short birth interval as being unintended (OR = 3.98; 95% CI: 1.73-9.16 and OR = 10.56; 95% CI: 1.80-61.83, respectively).
Although all women should be counseled on postpartum contraceptive use, findings suggest that important subpopulations of women may benefit from more targeted counseling during prenatal care visits and the immediate postpartum hospital stay regarding the importance of using contraception to not only better space pregnancies but also prevent unintended pregnancies.
美国三分之一的妊娠是在前次活产后 18 个月内受孕的。防止意外怀孕可能有助于降低这些妊娠间隔时间短的妊娠的发生率。然而,关于在生育间隔较短的女性中与妊娠意图相关的因素的数据很少。本研究使用妊娠风险评估监测系统(PRAMS)的数据来进一步评估这些关联。
由于只有密西西比州和田纳西州的 PRAMS 包括一个关于生育间隔长度的调查问题,因此本分析仅限于最近生育间隔较短的这两个州的女性(n=384)。妊娠意图以及人口统计学、生活方式和生殖数据来自调查和出生证明。使用逻辑回归获得比值比(OR)和 95%置信区间(CI)。
近 76%生育间隔较短的女性报告其妊娠为非意愿妊娠。非西班牙裔黑人或在怀孕期间饮酒的女性报告生育间隔较短的妊娠为非意愿妊娠的几率显著增加(OR=3.98;95%CI:1.73-9.16 和 OR=10.56;95%CI:1.80-61.83)。
尽管所有女性都应该接受产后避孕咨询,但研究结果表明,一些重要的女性亚群可能需要在产前护理就诊和产后住院期间更有针对性地接受咨询,以了解使用避孕不仅可以更好地间隔妊娠,而且可以预防意外妊娠的重要性。