Unintended pregnancy and maternal health complications: cross-sectional analysis of data from rural Uttar Pradesh, India

Abstract

Background: This study aims to explore the potential association between unintended pregnancy and maternal health complications. Secondarily, we test whether antenatal care (ANC) and community health worker (CHW) visits moderate the observed association between unintended pregnancy and maternal health complications. Methods: Cross sectional data were collected using a multistage sampling design to identify women who had a live birth in the last 12 months across 25 highest risk districts of Uttar Pradesh (N = 3659). Participants were surveyed on demographics, unintendedness of last pregnancy, receipt of ANC clinical visits and community outreach during pregnancy, and maternal complications. Regression models described the relations between unintended pregnancy and maternal complications. To determine if receipt of ANC and CHW visits in pregnancy moderated associations between unintended pregnancy and maternal complications, we used the Mantel-Haenzel risk estimation test and stratified logistic models testing interactions of unintended pregnancy and receipt of health services to predict maternal complications. Results: Around one-fifth of the women (16.9%) reported that their previous pregnancy was unintended. Logistic regression analyses revealed that unintended pregnancy was significantly associated with maternal complicationspre-eclampsia (AOR:2.06; 95% CI:1.57-2.72), postpartum hemorrhage (AOR:1.46; 95% CI: 1.01-2.13) and postpartum pre-eclampsia (AOR:2.34; 95% CI:1.47-3.72). Results from the Mantel Haenszel test indicated that both ANC and CHW home visit in pregnancy significantly affect the association between unintended pregnancy and postpartum hemorrhage (p < 0.001). Conclusion: Unintended pregnancy is associated with increased risk for maternal health complications, but provision of ANC clinical visits and CHW home visits in pregnancy may be able to reduce potential effects of unintended pregnancy on maternal health.

Determinants of Utilization of Institutional Delivery Services in Zambia: An Analytical Cross-Sectional Study

“…Finally, the present study showed that women whose blood pressure was measured during pregnancy had an increased likelihood of delivering at an institution with skilled attendants in comparison with women who did not have their blood pressure measured. One possible explanation for this finding is that women who had their blood pressure measured may have experienced pregnancy-related complications [ 48 ], which in turn made them vigilant and encouraged them to deliver their baby at an institution with skilled attendants. An earlier study looking at high blood pressure as a complication of pregnancy found that the presence of such complications was significantly associated with healthcare facility delivery [ 37 ].…”

Spatial distribution, prevalence, and determinants of unintended pregnancy among youth (15–24) in Ethiopia: Further analysis of Ethiopia Demographic and Health Survey

“…11 In addition to complications from unsafe abortion, unintended pregnancy has a number of consequences, including maternal depression and stress, 12 inadequate prenatal care, 13 and maternal complication like preeclampsia, postpartum preeclampsia, and hemorrhage. 12,14,15 Unintended pregnancy can be both the cause and consequence of dropping out of school. 16 Investment in the health of youth enables them to become healthy adults who are equipped to contribute positively to the society.…”

“…Unintended pregnancy among youth is also associated with economic status, partner disagreement on desired number of children, education, religion, place of residence, peers and partners behaviors, family and community attitudes, age, sexual violence, risky health behavior (early onset of sexual activity or unsafe sexual practices), and mass media. 14,19 –22…”

Association Between Maternal High-risk Fertility Behavior and Pregnancy Intention Among Women Aged 15 to 49 in Rwanda: Analysis of the 2014-15 Rwanda Demographic and Health Survey

“…Numerous studies have identi ed unintended pregnancy as a risk factor for maternal and infant mortality, as unintended pregnancy is associated with maternal complications such as pre-eclampsia, postpartum hemorrhage, and post-partum pre-eclampsia [5]. Furthermore, unintended pregnancy leads to increased rates of abortion [2,4,5]. In 2010-2014, 55% of the unintended pregnancies in developing regions ended in abortion [2].…”