Prevalence of and factors associated with unplanned pregnancy among women in Koshu, Japan: cross-sectional evidence from Project Koshu, 2011–2016

Huynh, Son Trung; Yokomichi, Hiroshi; Akiyama, Yuka; Kojima, Reiji; Horiuchi, Sayaka; Ooka, Tadao; Shinohara, Ryoji; Yamagata, Zentaro

doi:10.1186/s12884-020-03088-3

Cited by 14 publications

(8 citation statements)

References 63 publications

(86 reference statements)

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“…Multivariable analysis has shown that women’s desire to avoid pregnancy is associated with age, relationship status and number of children, which is consistent with the wider literature on the determinants of pregnancy intention 8 27–32. Future analyses could consider how desire to avoid pregnancy changes over time and as external factors, such as relationship status and education level, change.…”

Section: Discussionsupporting

confidence: 76%

Evaluation of the Desire to Avoid Pregnancy Scale in the UK: a psychometric analysis including predictive validity

2022

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ObjectivesTo evaluate the psychometric performance, including predictive validity, of a UK version of the Desire to Avoid Pregnancy (DAP) scale.DesignProspective cohort study for psychometric evaluation.SettingUK.ParticipantsWomen in the UK aged 15 years to menopause, who were not pregnant at the time of recruitment in October 2018, were eligible. 994 women completed the baseline survey and 90.2% of women eligible for the 12-month survey participated.Primary and secondary outcome measuresThe DAP scale was assessed according to key measurement properties of validity (construct (structural and hypothesis testing) and criterion (predictive)), reliability (internal consistency using Cronbach’s alpha and test–retest using intraclass correlation coefficients, ICC) and differential item functioning. Item response and classical test theory methods were used.ResultsThe scale was acceptable, understandable and showed good targeting with the full range of scores captured. Construct validity was demonstrated on hypothesis testing, with odds of contraceptive use increasing threefold with each increasing DAP point (range: 0–4). Eighty per cent of women with the lowest DAP score became pregnant within 12 months, compared with <1% of those with the highest DAP score. Reliability, both in terms of internal consistency (Cronbach’s α 0.96) and test–retest (ICC 0.95), was excellent. Some tests of structural validity, in relation to model fit with the item-response model, were not met, and investigations suggest further exploration of the factor structure of the DAP is required in other samples. Item 5, regarding relationship with a partner, showed differential item functioning by age, number of children and relationship group.ConclusionsThe UK DAP is a valid and reliable measure of women’s DAP and is highly predictive of pregnancy within the next 12 months. Further evaluations should continue the assessment of the factor structure and the performance of the item relating to the partner.

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Section: Discussionsupporting

confidence: 76%

Evaluation of the Desire to Avoid Pregnancy Scale in the UK: a psychometric analysis including predictive validity

2022

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“…Our finding that late- or non-stoppers initiate prenatal care later and have fewer face-to-face visits with the midwife could possibly be explained by the pregnancy recognition time. Previous studies reported that smoking during pregnancy is associated with unplanned pregnancy [ 28 ], leading to a later initiation of care and less prenatal visits [ 29 ]. Although the late- or non-stoppers initiate maternal care significantly later, our results do not indicate that either early stoppers or late- or non- stoppers have inadequate use of care.…”

Section: Discussionmentioning

confidence: 99%

Women who smoke during pregnancy are more likely to be referred to an obstetrician during pregnancy and birth: results from a cohort study

Weiland

Peters

Berger

et al. 2022

BMC Pregnancy Childbirth

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Background Women who smoke during pregnancy make less use of prenatal care; the relation of smoking behavior with the use of other forms of maternal healthcare is unknown. The objective of this study is to investigate the association between women’s smoking behavior and their use of healthcare during pregnancy, birth and six weeks postpartum. Methods We analyzed data from the Dutch Midwifery Case Registration System (VeCaS), period 2012–2019. We included women with a known smoking status, singleton pregnancies, and who had their first appointment before 24 weeks of gestation with the primary care midwife. We compared three groups: non-smokers, early stoppers (stopped smoking in the first trimester), and late- or non-stoppers (stopped smoking after the first trimester or continued smoking). Descriptive statistics were used to report maternal healthcare utilization (during pregnancy, birth and six weeks postpartum), statistical differences between the groups were calculated with Kruskal–Wallis tests. Multivariable logistic regression was conducted to assess the association between smoking behavior and referrals to primary, secondary or tertiary care. Results We included 41 088 pregnant women. The groups differed significantly on maternal healthcare utilization. The late- or non-stoppers initiated prenatal care later and had less face-to-face consultations with primary care midwives during pregnancy. Compared to the non-smokers, the early- and late- or non-stoppers were statistically signficiantly more likely to be referred to the obstetrician during pregnancy and birth. Postpartum, the early- and late- or non-stoppers were statistically signficantly less likely to be referred to the obstetrician compared to the non-smokers. Conclusions Although the early- and late- or non-stoppers initiated prenatal care later than the non-smokers, they did receive adequate prenatal care (according to the recommendations). The results suggest that not smoking during pregnancy may decrease the likelihood of referral to secondary or tertiary care. The large population of smokers being referred during pregnancy underlines the important role of the collaboration between healthcare professionals in primary and secondary or tertiary care. They need to be more aware of the importance of smoking as a medical and as a non-medical risk factor.

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“…27 Of increasing importance in a world of rising non-communicable diseases is the reduced opportunity for pre-pregnancy optimization of chronic medical conditions such as diabetes and obesity as well as the impact on mental health conditions such as depression, or of the chance to review potentially teratogenic medications. 28…”

Section: Why Do We Need To Know About Pregnancy Intention?mentioning

confidence: 99%

Measures of Pregnancy Intention: Why Use Them and What Do They Tell Us?

et al. 2022

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Understanding pregnancy intention is an important public health measure that captures the ability of individuals to access information, resources, and services needed to plan the timing and spacing of pregnancies. Pregnancy intention is a complex construct impacted by social, emotional, financial, cultural, and contextual factors. In this review, we will examine the range of available tools for individuals and populations to evaluate pregnancy intention, the timing of the tools in relation to pregnancy, their interpretation, and use for policy and practice. Traditionally, pregnancy intention was only assessed in population health surveys; however, more sophisticated tools and measures have been developed. These tools can be used at several time points: before pregnancy, during pregnancy, or after the pregnancy has ended. It is important to appreciate the varied contexts globally for women and their partners when assessing pregnancy intention, and the ability of a given tool to capture this when used retrospectively or prospectively. These tools can inform targeted delivery of services for a person or couple before, during, and after pregnancy. This knowledge can inform strategies at an individual, community, and population level as an indicator of access to sexual and reproductive health information and knowledge and uptake of preconception health.

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Prevalence of and factors associated with unplanned pregnancy among women in Koshu, Japan: cross-sectional evidence from Project Koshu, 2011–2016

Cited by 14 publications

References 63 publications

Evaluation of the Desire to Avoid Pregnancy Scale in the UK: a psychometric analysis including predictive validity

Evaluation of the Desire to Avoid Pregnancy Scale in the UK: a psychometric analysis including predictive validity

Women who smoke during pregnancy are more likely to be referred to an obstetrician during pregnancy and birth: results from a cohort study

Measures of Pregnancy Intention: Why Use Them and What Do They Tell Us?

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