Obstetrical, Perinatal, and Pediatric Epidemiology Team (Epopé), Center of Research in Epidemiology and Statistics, Université Paris Cité, INSERM, 75014 Paris, France.
Obstetrical, Perinatal, and Pediatric Epidemiology Team (Epopé), Center of Research in Epidemiology and Statistics, Université Paris Cité, INSERM, 75014 Paris, France.
J Gynecol Obstet Hum Reprod. 2023 Sep;52(7):102608. doi: 10.1016/j.jogoh.2023.102608. Epub 2023 May 27.
Evaluate the association between a combined measure of time-based pregnancy intention and preconception contraceptive behavior and suboptimal prenatal care.
Women delivering a live birth in all maternity units during one week in March 2016 were interviewed in the postpartum ward (N = 13,132). Multinomial logistic regression models were used to assess the association between the indicator of pregnancy intention and substandard prenatal care (late initiation of care and less than the recommended number of prenatal visits (<60% recommended)).
83.6% of women had timed pregnancies, 4.7% had mistimed pregnancies but discontinued contraception to conceive, 8.0% had mistimed pregnancies without discontinuing contraception to conceive and 3.7% had unwanted pregnancies. Women with timed pregnancies or mistimed pregnancies despite discontinuing contraception to conceive were more socially advantaged than those who had an unwanted pregnancy or a mistimed pregnancy without discontinuing contraception to conceive. 3.3% of women had a substandard number of prenatal visits and 2.5% had delayed prenatal care initiation. The adjusted odds ratios (aOR) of substandard prenatal visits were high among women with unwanted pregnancies (aOR=2.78; 95% confidence interval [1.91-4.05]) and women with mistimed pregnancies who had not discontinued contraception to conceive (aOR=1.69; [1.21-2.35]) compared to women with timed pregnancies. No difference was observed for women with mistimed pregnancies who discontinued contraception to conceive (aOR=1.22; [0.70-2.12]).
Using routinely collected information on preconception contraception allows a more nuanced assessment of pregnancy intentions that can help caregivers identify women at greater risk of substandard prenatal care.
评估基于时间的妊娠意向综合指标与孕前避孕行为和产前护理不足之间的关联。
2016 年 3 月一周内在所有产科病房分娩的活产妇女在产后病房接受访谈（N=13132）。使用多项逻辑回归模型评估妊娠意向指标与产前护理不足（护理开始晚和产前就诊次数少于推荐数（<60%推荐））之间的关联。
83.6%的妇女有计划妊娠，4.7%的妇女意外妊娠但已停止避孕，8.0%的妇女意外妊娠且未停止避孕，3.7%的妇女意外妊娠。有计划妊娠或意外妊娠但已停止避孕的妇女比意外妊娠或意外妊娠且未停止避孕的妇女社会地位更高。3.3%的妇女产前就诊次数不足，2.5%的妇女产前护理开始延迟。与有计划妊娠的妇女相比，意外妊娠的妇女（调整后的优势比[aOR]=2.78；95%置信区间[1.91-4.05]）和意外妊娠且未停止避孕的妇女（aOR=1.69；[1.21-2.35]）有更高的产前护理不足的调整后比值比[aOR]。与意外妊娠且已停止避孕的妇女（aOR=1.22；[0.70-2.12]）相比，意外妊娠但未停止避孕的妇女（aOR=1.22；[0.70-2.12]）没有差异。
利用常规收集的孕前避孕信息，可以更细致地评估妊娠意向，有助于护理人员识别产前护理不足风险较高的妇女。
