Omani-Samani Reza, Ranjbaran Mehdi, Mohammadi Maryam, Esmailzadeh Arezoo, Sepidarkish Mahdi, Maroufizadeh Saman, Almasi-Hashiani Amir
1Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Bani Hashem Place, Hafez St., P.O. Box: 16635148, Tehran, Iran.
2Department of Obstetrics and Gynecology, Zahedan University of Medical Sciences, Zahedan, Iran.
J Obstet Gynaecol India. 2019 Apr;69(2):136-141. doi: 10.1007/s13224-018-1125-5. Epub 2018 May 16.
Pregnancy outcomes might be affected by unintended pregnancy such as preeclampsia, preterm birth, cesarean section and low birth weight. The aim of the present study is to assess the association between unintended pregnancy and pregnancy outcomes.
This was a cross-sectional study conducted in 103 hospitals in Tehran, Iran, in July 2015. The data were collected by trained midwives. The interested independent variable was unintended pregnancy and also preeclampsia, weight gain during pregnancy, preterm birth, cesarean section and low birth weight were considered as interested outcomes, and the association of unintended pregnancy and interested outcomes were assessed.
Out of 5152 cases, 1021 (19.82%) cases were unintended pregnancy. There was no significant relationship between unintended pregnancy and low birth weight (adjusted OR 0.67, 95% CI 0.403-1.13, = 0.138), the risk of preterm birth (adjusted OR 1.15, 95% CI 0.850-1.57, = 0.351) and preeclampsia (adjusted OR 1.21, 95% CI 0.846-1.75, = 0.289). The results of multiple linear regression model showed that the mean difference between two groups was 0.70 kg, and weight gain mean in unintended pregnant women significantly was lower than unintended pregnant women (mean difference = 0.70, 95% CI 0.14-1.26 kg, = 0.014). Multiple logistic regression showed that after adjusting confounders, there was a significant relationship between unintended pregnancy and cesarean section, and the adjusted odds of cesarean section in unintended pregnant women was 1.32 times of intended pregnant women (95% CI 1.07-1.63, = 0.009).
We found higher risk of cesarean section and inappropriate weight gain during pregnancy as adverse outcomes of unintended pregnancy in adjusted model.
意外怀孕可能会影响妊娠结局,如子痫前期、早产、剖宫产和低出生体重。本研究的目的是评估意外怀孕与妊娠结局之间的关联。
这是一项于2015年7月在伊朗德黑兰的103家医院进行的横断面研究。数据由经过培训的助产士收集。感兴趣的自变量是意外怀孕,子痫前期、孕期体重增加、早产、剖宫产和低出生体重也被视为感兴趣的结局,并评估意外怀孕与感兴趣结局之间的关联。
在5152例病例中,1021例(19.82%)为意外怀孕。意外怀孕与低出生体重(调整后的比值比为0.67,95%置信区间为0.403 - 1.13,P = 0.138)、早产风险(调整后的比值比为1.15,95%置信区间为0.850 - 1.57,P = 0.351)和子痫前期(调整后的比值比为1.21,95%置信区间为0.846 - 1.75,P = 0.289)之间无显著关系。多元线性回归模型结果显示,两组之间的平均差异为0.70千克,意外怀孕女性的体重增加平均值显著低于非意外怀孕女性(平均差异 = 0.70,95%置信区间为0.14 - 1.26千克,P = 0.014)。多元逻辑回归显示,在调整混杂因素后,意外怀孕与剖宫产之间存在显著关系,意外怀孕女性剖宫产的调整后比值是计划怀孕女性的1.32倍(95%置信区间为1.07 - 1.63,P = 0.009)。
在调整模型中,我们发现剖宫产风险增加和孕期体重增加不当是意外怀孕的不良结局。