Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA.
BMJ Open. 2023 May 2;13(5):e068689. doi: 10.1136/bmjopen-2022-068689.
Among youth in Nairobi, we (1) characterised fertility and contraceptive use dynamics by gender; (2) estimated pregnancy prevalence over the pandemic; and (3) assessed factors associated with unintended pandemic pregnancy for young women.
Longitudinal analyses use cohort data collected at three timepoints prior to and during the COVID-19 pandemic: June to August 2019 (pre-pandemic), August to October 2020 (12-month follow-up) and April to May 2021 (18-month follow-up).
Nairobi, Kenya.
At initial cohort recruitment, eligible youth were aged 15-24 years, unmarried and residing in Nairobi for at least 1 year. Within-timepoint analyses were restricted to participants with survey data per round; trend and prospective analyses were restricted to those with complete data at all three timepoints (n=586 young men, n=589 young women).
Primary outcomes comprised fertility and contraceptive use for both genders, and pregnancy for young women. Unintended pandemic pregnancy (assessed at 18-month follow-up) was defined as a current or past 6-month pregnancy with intent to delay pregnancy for more than 1 year at 2020 survey.
While fertility intentions remained stable, contraceptive dynamics varied by gender-young men both adopted and discontinued coital-dependent methods, whereas young women adopted coital-dependent or short-acting methods at 12-month follow-up (2020). Current pregnancy was highest at 2020 (4.8%), and approximately 2% at 2019 and 2021. Unintended pandemic pregnancy prevalence was 6.1%, with increased odds for young women recently married (adjusted OR (aOR)=3.79; 95% confidence interval (CI) 1.83-7.86); recent contraceptive use was protective against unintended pandemic pregnancy (aOR=0.23; 95% CI 0.11-0.47).
Current pregnancy in Nairobi was highest at the height of the COVID-19 pandemic (2020), and subsided to pre-pandemic levels by 2021 data collection; however, requires further monitoring. New marriages posed considerable risk for unintended pandemic pregnancy. Contraceptive use remains a crucial preventive strategy to averting unintended pregnancy, particularly for married young women.
在奈洛比的年轻人中，（1）我们按性别描述了生育和避孕措施的动态变化；（2）估计了大流行期间的妊娠流行率；（3）评估了与年轻女性意外大流行妊娠相关的因素。
使用在 COVID-19 大流行之前和期间三个时间点收集的队列数据进行纵向分析：2019 年 6 月至 8 月（大流行前）、2020 年 8 月至 10 月（12 个月随访）和 2021 年 4 月至 5 月（18 个月随访）。
肯尼亚内罗毕。
在最初的队列招募中，符合条件的年轻人年龄在 15-24 岁之间，未婚，在内罗毕居住至少 1 年。在每个时间点的分析中，仅限于每个轮次都有调查数据的参与者；趋势和前瞻性分析仅限于所有三个时间点都有完整数据的参与者（586 名年轻男性，589 名年轻女性）。
主要结果包括两性的生育和避孕措施以及年轻女性的妊娠情况。意外大流行妊娠（在 18 个月随访时评估）被定义为当前或过去 6 个月的妊娠，在 2020 年调查时意图将妊娠推迟 1 年以上。
虽然生育意愿保持稳定，但避孕措施的动态因性别而异-年轻男性采用并停止了依赖性行为的方法，而年轻女性在 12 个月随访时（2020 年）采用了依赖性行为或短效方法。当前妊娠率在 2020 年最高（4.8%），而 2019 年和 2021 年约为 2%。意外大流行妊娠的流行率为 6.1%，最近结婚的年轻女性的几率更高（调整后的比值比（aOR）=3.79；95%置信区间（CI）1.83-7.86）；最近使用避孕措施可预防意外大流行妊娠（aOR=0.23；95%CI 0.11-0.47）。
奈洛比的当前妊娠率在 COVID-19 大流行高峰期（2020 年）最高，到 2021 年数据收集时已降至大流行前水平；但是，需要进一步监测。新婚姻对意外大流行妊娠构成了相当大的风险。避孕仍然是避免意外怀孕的重要预防策略，特别是对已婚的年轻女性。
