Lansdale Aimee J, Puri Mahesh C, Diamond-Smith Nadia
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA (Lansdale and Diamond-Smith).
Center for Research on Environment Health and Population Activities (CREHPA), Kathmandu, Nepal (Puri).
AJOG Glob Rep. 2024 Oct 9;4(4):100403. doi: 10.1016/j.xagr.2024.100403. eCollection 2024 Nov.
Approximately 44% of Nepalese women ages 15-49, desiring to avoid pregnancy, do not use modern contraceptives, resulting in an estimated 539,000 unintended pregnancies annually.
This study aims to investigate the association between young, newly married women's pregnancy intentions and subsequent pregnancies.
Data were collected longitudinally from 200 recently married women ages 18-25 in Nepal. Surveys conducted every six months over 18 months covered various health domains. The study used mixed-effects logistic regression models to account for repeated measurement of correlated data over time. The primary outcome was pregnancy. Pregnancy intention was determined based on responses to, "When would you like to have a child in case you were to have one?" Participants were recategorized into a dichotomous variable for analytical purposes: "Right away" or "Not right away."
A total of 133 participants became pregnant during the study, with sociodemographic characteristics showing minimal differences between pregnant and nonpregnant groups. Women intending to become pregnant right away had significantly higher odds of becoming pregnant (OR, 4.03; 95% CI, 2.51-6.48) after adjusting for covariates. Among those not intending immediate pregnancy, over 70% became pregnant, suggesting potential barriers to achieving reproductive goals.
Young, newly married women in Nepal intending immediate pregnancy have higher odds of becoming pregnant. However, a substantial proportion of those hoping to delay pregnancy still experience unintended pregnancies, indicating challenges in meeting reproductive goals. The findings underscore the need for addressing barriers to contraceptive access and societal norms impacting women's reproductive autonomy in Nepal.
在尼泊尔，年龄在15至49岁且希望避免怀孕的女性中，约44%未使用现代避孕方法，这导致每年估计有53.9万例意外怀孕。
本研究旨在调查年轻的新婚女性的怀孕意愿与随后怀孕之间的关联。
从尼泊尔200名年龄在18至25岁的新婚女性中纵向收集数据。在18个月内每六个月进行一次调查，涵盖多个健康领域。该研究使用混合效应逻辑回归模型来处理随时间对相关数据的重复测量。主要结局是怀孕。怀孕意愿根据对“如果你要生孩子，你希望什么时候生？”的回答来确定。为了分析目的，参与者被重新分类为一个二分变量：“马上”或“不马上”。
在研究期间，共有133名参与者怀孕，怀孕组和未怀孕组的社会人口学特征差异极小。在调整协变量后，打算马上怀孕的女性怀孕的几率显著更高（比值比，4.03；95%置信区间，2.51 - 6.48）。在那些不打算立即怀孕的女性中，超过70%怀孕了，这表明实现生殖目标存在潜在障碍。
尼泊尔年轻的新婚女性中，打算立即怀孕的女性怀孕几率更高。然而，很大一部分希望推迟怀孕的女性仍然经历意外怀孕，这表明在实现生殖目标方面存在挑战。这些发现强调了在尼泊尔解决避孕获取障碍以及影响女性生殖自主权的社会规范的必要性。
