Division of Epidemiology, College of Public Health, Ohio State University, Columbus, Ohio, USA.
Advocate Aurora Research Institute, Aurora Health Care, Advocate Health, Miwaukee, WI, USA.
Paediatr Perinat Epidemiol. 2024 Jan;38(1):56-65. doi: 10.1111/ppe.13014. Epub 2023 Oct 23.
Most rapid repeat pregnancies, defined as those occurring within 18 months of a previous birth, are unintended. These pregnancies are associated with later initiation of prenatal care and are more common among people with lower socio-economic status and among racially and ethnically minoritised populations.
To assess prevalence and correlate pregnancies occurring in the immediate period after a live birth in the United States, using the Pregnancy Risk Assessment Monitoring System (PRAMS).
We assessed data from the 2009-2020 PRAMS, a population-based survey of perinatal maternal characteristics of mothers of liveborn infants in US locations. We assessed pregnancies reported during the immediate postpartum period (approximately 2-6 months post-delivery), and term this 'very rapid repeat pregnancy' (VRRP). We assessed the adjusted prevalence of VRRP from 2009 to 2020. From 2016 to 2020, we calculated adjusted prevalence ratios (aPR) with 95% confidence intervals (CI) for maternal characteristics.
The adjusted prevalence of VRRP ranged from 0.38% (95% CI: 0.29, 0.48) in 2009 to 0.76% (95% CI: 0.61, 0.91) in 2020. Demographic characteristics associated with VRRP included younger age, lower educational attainment, and being unmarried. Black mothers had a higher prevalence of VRRP compared to white mothers. Mothers who attended a healthcare visit in the 12 months preconception had a lower prevalence of VRRP as did mothers who attended a postpartum check-up, compared to their counterparts without these visits. Among those receiving prenatal care, mothers whose prenatal healthcare provider asked about postpartum contraception birth had a lower prevalence of VRRP, compared to those not asked about postpartum contraception.
VRRP appeared to increase over time in 2009-2020. Mothers who are younger, Black, have lower educational attainment, or who did not attend healthcare visits before or after pregnancy had a higher prevalence of VRRP and may comprise a population who would benefit from additional family planning resources.
大多数快速重复妊娠（定义为在前一次分娩后 18 个月内发生的妊娠）都是非意愿的。这些妊娠与产前保健的较晚开始有关，在社会经济地位较低的人群以及在种族和族裔少数民族中更为常见。
使用妊娠风险评估监测系统（PRAMS）评估美国活产后立即发生妊娠的流行率并分析其相关因素。
我们评估了来自 2009 年至 2020 年 PRAMS 的数据，这是一项针对美国活产婴儿母亲围产期特征的基于人群的调查。我们评估了产后期间（分娩后约 2-6 个月）报告的妊娠，并将其称为“非常快速重复妊娠”（VRRP）。我们评估了 2009 年至 2020 年 VRRP 的调整后流行率。2016 年至 2020 年，我们计算了与母亲特征相关的调整后患病率比（aPR）及其 95%置信区间（CI）。
VRRP 的调整后流行率从 2009 年的 0.38%（95%CI：0.29，0.48）到 2020 年的 0.76%（95%CI：0.61，0.91）不等。与 VRRP 相关的人口统计学特征包括年龄较小、教育程度较低和未婚。与白人母亲相比，黑人母亲的 VRRP 发生率更高。与没有这些就诊的母亲相比，在妊娠前 12 个月就诊的母亲以及产后检查就诊的母亲，VRRP 的发生率较低。在接受产前保健的母亲中，与没有被询问产后避孕的母亲相比，其产前保健提供者询问产后避孕的母亲，VRRP 的发生率较低。
在 2009 年至 2020 年期间，VRRP 似乎呈上升趋势。较年轻、黑人、教育程度较低或在妊娠前后未就诊的母亲，VRRP 发生率较高，可能构成需要额外计划生育资源的人群。
