Aragaw Fantu Mamo, Amare Tsegaw, Teklu Rediet Eristu, Tegegne Biresaw Ayen, Alem Adugnaw Zeleke
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Front Reprod Health. 2023 Jul 17;5:1113926. doi: 10.3389/frph.2023.1113926. eCollection 2023.
Unintended pregnancy is one of the most serious health issues in low and Middle-Income Countries (LMICs), posing significant health, economic, and psychosocial costs to individuals and communities. However, there is limited evidence on the prevalence of unintended pregnancies and their determinants in LMICs. Hence, this study aimed to assess the prevalence of unintended pregnancy and its associated factors among childbearing-age women in LMICs.
Data for the study were drawn from a recent 61 Demographic and Health Surveys (DHS) conducted in LMICs. A total sample of 187,347 mothers who gave birth in the five years preceding the survey was included. STATA version 16 was used to clean and analyze the data. Multilevel multivariable logistic regression was employed to identify individual and community-level factors of unintended pregnancy in LMICs. In the multivariable analysis, an adjusted odds ratio with a 95% confidence level was reported to indicate statistical association.
The pooled magnitude of unintended pregnancy in LMICs was 26.46%% (95% CI: 25.30%, 27.62%), ranging from 19.25%% in Egypt to 61.71% in Bolivia. Working status (AOR = 1.03; 95% CI: 1.01, 1.06), having a husband with no education (AOR = 1.07; 95% CI: 1.00, 1.15), and primary education (AOR = 1.05; 95% CI: 1.01, 1.11), women from male-headed households (AOR = 1.04; 95% CI: 1.00, 1.08), media exposure (AOR = 1.05; 95% CI: 1.02, 1.08), unmet need for contraception (AOR = 1.05; 95% CI: 1.02, 1.08), distance from a health facility (AOR = 1.03; 95% CI: 1.00, 1.06) were significantly associated with unintended pregnancy.
Unintended pregnancy rates remain high in LMICs. Women whose husband has no education and primary education, women with media exposure, working status, women who live in a household headed by male, women with unmet need for contraception, and women with a big problem of distance to health facilities were variables that were significant predictors of unintended pregnancy. When attempting to minimize unintended pregnancy in LMICs, these factors need to be considered. Furthermore, most of these attempts should be driven by government entities in low and middle-income countries.
意外怀孕是低收入和中等收入国家（LMICs）最严重的健康问题之一，给个人和社区带来了巨大的健康、经济和心理社会成本。然而，关于LMICs中意外怀孕的患病率及其决定因素的证据有限。因此，本研究旨在评估LMICs中育龄妇女意外怀孕的患病率及其相关因素。
本研究的数据来自最近在LMICs进行的61次人口与健康调查（DHS）。纳入了在调查前五年内分娩的187,347名母亲的总样本。使用STATA 16版本清理和分析数据。采用多水平多变量逻辑回归来确定LMICs中意外怀孕的个体和社区层面因素。在多变量分析中，报告了具有95%置信水平的调整后优势比，以表明统计关联。
LMICs中意外怀孕的合并患病率为26.46%（95%CI：25.30%，27.62%），范围从埃及的19.25%到玻利维亚的61.71%。工作状态（AOR = 1.03；95%CI：1.01，1.06）、丈夫未受过教育（AOR = 1.07；95%CI：1.00，1.15）、小学教育（AOR = 1.05；95%CI：1.01，1.11）、来自男性户主家庭的女性（AOR = 1.04；95%CI：1.00，1.08）、媒体曝光（AOR = 1.05；95%CI：1.02，1.08）、未满足的避孕需求（AOR = 1.05；95%CI：1.02，1.08）、与医疗机构的距离（AOR = 1.03；95%CI：1.00，1.06）与意外怀孕显著相关。
LMICs中的意外怀孕率仍然很高。丈夫未受过教育和小学教育的女性、有媒体曝光的女性、有工作的女性、生活在男性户主家庭中的女性、有未满足避孕需求的女性以及距离医疗机构较远的女性是意外怀孕的重要预测变量。在试图将LMICs中的意外怀孕降至最低时，需要考虑这些因素。此外，这些努力大多应由低收入和中等收入国家的政府实体推动。
