Impact of unplanned pregnancy on neonatal outcomes: findings of new high-risk newborns in Peru

Abstract

Background Unplanned pregnancy is a significant public health problem, especially in low- to middle-income countries. The objective of this study was to determine the neonatal outcomes associated with unplanned pregnancy in a public hospital in southern Peru. Methods A cross-sectional analytical study was conducted from June to August 2021 among 306 mothers and their newborns selected by convenience sampling. After obtaining informed consent, mothers were surveyed during their postpartum hospitalization about their pregnancy intentions. Unintended pregnancy was considered when it was mistimed or unwanted. Neonatal outcomes were assessed by reviewing medical records prior to discharge, evaluating the presence of low birth weight, insufficient birth weight, prematurity, respiratory distress syndrome, sepsis and neonatal mortality. Association was measured in terms of prevalence ratio (PR) and beta coefficient and respective 95% CIs, crude and adjusted for variables that obtained a value of p<0.20 in the crude model (maternal age, education and parity). Results The overall unplanned pregnancies was 65%, of which 40.5% were mistimed pregnancies and 24.5% unwanted pregnancies. Unplanned and mistimed pregnancies were significantly associated with insufficient birth weight [adjusted prevalence ratio (aPR)=2.14; 95% CI 1.01 to 4.56 and aPR=2.43; 95% CI 1.09 to 5.39, respectively] and unwanted pregnancies were significantly associated with preterm birth (aPR=3.49; 95% CI 1.01 to 12.11). Furthermore, adjusted analysis showed that birth weight and gestational age were lower in unplanned, mistimed and unwanted pregnancies. Conclusions Unplanned pregnancy was associated with lower birth weight and shorter gestational age of newborns. These data collected in a public hospital in a developing country may have significant implications today. If pregnancy intention is not included as a neonatal risk factor, insufficient birth weight and preterm birth could increase because a higher proportion of births will be unplanned.

Pregnancy intention in relation to maternal and neonatal outcomes in women with versus without psychiatric diagnoses

“…We found that on itself, UPs were not related to adverse maternal or neonatal outcomes. Our findings oppose most previous studies that showed robust associations between UPs and adverse outcomes in retrospective studies, prospective studies [43][44][45] and meta-analysis originating from various geographic regions. 16,17 However, a recent large Swedish prospective cohort study found no association between UPs and severe pregnancy outcomes such as hypertensive disorders of pregnancy, gestational diabetes mellitus, assisted birth or cesarean section.…”

Gravidez não planejada no extremo Sul do Brasil: prevalência, tendência e fatores associados

“…Nenhum fator isolado tem tantos benefícios à saúde materno-infantil como escolaridade 26 . Ao melhorar a escolaridade, as mulheres passam a ter acesso a informações essenciais para cuidar de sua saúde e a de seus filhos, adquirem habilidades argumentativas, conhecem melhor seus direitos e passam a participar de forma mais efetiva da vida social, incluindo ocupação de postos no mercado de trabalho 4,27 . Ao fazer isso, aumentam a renda familiar, melhoram o poder de compra, sua condição de vida e a da sua família.…”

“…Dentre as 213 milhões de gravidezes ocorridas em 2012, a mais recente estimativa disponível, cerca de 85 milhões delas não foram planejadas 1 . Este tipo de gravidez está associado ao início tardio das consultas, a realização de pré-natal inadequado e a resultados adversos como baixo peso ao nascer, prematuridade, necessidade de indução do trabalho de parto e maior tempo de internação [2][3][4][5] . Além disso, essas mulheres são, em geral, de menor idade, solteiras ou sem companheiro, de baixo nível socioeconómico e, muito frequentemente, vítimas de violência por parceiro íntimo 6,7 .…”