EGA Institute for Women's Health, University College London, London, United Kingdom.
Ministry of Health, Lilongwe, Malawi.
PLoS One. 2022 Mar 14;17(3):e0263877. doi: 10.1371/journal.pone.0263877. eCollection 2022.
Despite growing evidence of pregnancy preparation benefits, there is little knowledge on how women in developing countries prepare for pregnancy and factors influencing their preparedness for pregnancy. Here, we determine how women in Malawi prepare for pregnancy and factors associated with pregnancy preparation.
We used data from a previous cohort study comprising 4,244 pregnant mothers, recruited between March and December 2013 in Mchinji district, Malawi. Associations of pregnancy preparation with socio-demographic and obstetric factors were tested for using mixed effects ordinal regression, with the likelihood ratio and Wald's tests used for variable selection and independently testing the associations.
Most mothers (63.9%) did not take any action to prepare for their pregnancies. For those who did (36.1%), eating more healthily (71.9%) and saving money (42.8%) were the most common forms of preparation. Mothers who were married (adjusted odds-ratio (AOR 7.77 (95% CI [5.31, 11.25]) or with no or fewer living children were more likely to prepare for pregnancy (AOR 4.71, 95% CI [2.89,7.61]. Mothers with a period of two to three years (AOR 2.51, 95% CI [1.47, 4.22]) or at least three years (AOR 3.67, 95%CI [2.18, 6.23]) between pregnancies were more likely to prepare for pregnancy than women with first pregnancy or shorter intervals. On the other hand, teenage and older (≥ 35 years old) mothers were less likely to prepare for pregnancy (AOR 0.61, 95%CI [0.47, 0.80]) and AOR 0.49 95%CI [0.33, 0.73], respectively).
While preconception care may not be formally available in Malawi, our study has revealed that over a third of mothers took some action to prepare for pregnancy before conception. Although this leaves around two thirds of women who did not make any form of pregnancy preparation, our findings form a basis for future research and development of a preconception care package that suits the Malawian context.
尽管越来越多的证据表明妊娠准备有好处，但对于发展中国家的女性如何为妊娠做准备以及影响其妊娠准备的因素知之甚少。在这里，我们确定马拉维的女性如何为妊娠做准备以及与妊娠准备相关的因素。
我们使用了之前一项队列研究的数据，该研究共纳入了 2013 年 3 月至 12 月在马拉维姆钦吉区招募的 4244 名孕妇。使用混合效应有序回归检验妊娠准备与社会人口统计学和产科因素的关联，使用似然比和 Wald 检验进行变量选择，并分别检验关联。
大多数母亲（63.9%）没有采取任何措施为怀孕做准备。对于那些有准备的母亲（36.1%），吃得更健康（71.9%）和存钱（42.8%）是最常见的准备形式。已婚母亲（调整后的优势比（AOR）7.77（95%CI[5.31,11.25]）或没有或更少孩子的母亲更有可能为怀孕做准备（AOR 4.71，95%CI[2.89,7.61]）。生育间隔为 2 至 3 年（AOR 2.51，95%CI[1.47,4.22]）或至少 3 年（AOR 3.67，95%CI[2.18,6.23]）的母亲比首次怀孕或生育间隔较短的母亲更有可能为怀孕做准备。另一方面，青少年和年龄较大（≥35 岁）的母亲不太可能为怀孕做准备（AOR 0.61，95%CI[0.47,0.80]）和 AOR 0.49 95%CI[0.33,0.73]）。
虽然马拉维可能没有正式的孕前保健，但我们的研究表明，超过三分之一的母亲在怀孕前采取了一些措施为怀孕做准备。尽管这使得大约三分之二的女性没有进行任何形式的妊娠准备，但我们的研究结果为未来研究和开发适合马拉维背景的孕前保健套餐奠定了基础。
