Pregnancy intention and its relationship to birth and maternal outcomes
Pregnancy intention and its relationship to birth and maternal outcomes
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DOI：
10.1097/01.aog.0000255666.78427.c5
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发表时间：
2007-03-01
影响因子：
7.2
通讯作者：
Marchbanks, P. A.
中科院分区：
文献类型：
--
作者：
Mohllajee, A. P.;Curtis, K. M.;Marchbanks, P. A.
目的：研究妊娠意向（有意的、不希望的、不合时宜的或矛盾的）与不良出生和产妇结局（低出生体重（小于2500克）、早产（少于37周）、小于胎龄、早产、高血压和其他产妇结局）之间是否存在关联。方法：我们分析了基于人群的妊娠风险评估监测系统的数据，包括1996年至1999年间在18个州分娩的87,087名妇女。有关妊娠结局的信息来自出生证明数据和产后完成的自我管理问卷。我们采用SUDAAN （RTI International, Research Triangle Park， NC）进行单变量和逻辑回归分析。结果：在控制人口统计学和行为因素的分析中，意外怀孕的妇女与计划怀孕的妇女相比，早产（调整优势比[OR] 1.16, 95%可信区间[CI] 1.01-1.33）和胎膜早破（调整优势比[OR] 1.37, 95%可信区间[CI] 1.01-1.85）的可能性增加。对怀孕持矛盾态度的妇女分娩低出生体重婴儿的几率增加（调整后OR为1.15,95% CI为1.02-1.29）；相反，不合时宜怀孕的妇女有较低的可能性（调整OR 0.92, 95% CI 0.86-0.97）。结论：怀孕意向，特别是不希望的和矛盾的，可能是一些不良分娩和孕产妇结局风险增加的一个指标，应在旨在改善母婴健康的干预措施中予以考虑。
OBJECTIVE: To examine whether there are associations between pregnancy intention (intended, unwanted, mistimed, or ambivalent) and negative birth and maternal outcomes: low birth weight (less than 2,500 g), preterm delivery (fewer than 37 weeks), small for gestational age, premature labor, hypertension, and other maternal outcomes.METHODS: We analyzed data from the population-based Pregnancy Risk Assessment Monitoring System, including 87,087 women who gave birth between 1996 and 1999 in 18 states. Information on pregnancy outcomes was derived from birth certificate data and a self-administered questionnaire completed postpartum. We employed SUDAAN (RTI International, Research Triangle Park, NC) for univariable and logistical regression analyses.RESULTS: In analyses controlling for demographic and behavioral factors, women with unwanted pregnancies had an increased likelihood of preterm delivery (adjusted odds ratio [OR] 1.16, 95% confidence interval [CI] 1.01-1.33) and premature rupture of membranes (adjusted OR 1.37, 95% CI 1.01-1.85) compared with women with intended pregnancies. Women who were ambivalent toward their pregnancies had increased odds of delivering a low birth weight infant (adjusted OR 1.15, 95% CI 1.02-1.29); in contrast, women with mistimed pregnancies had a lower likelihood (adjusted OR 0.92, 95% CI 0.86-0.97).CONCLUSION: Pregnancy intention, specifically unwanted and ambivalent, may be an indicator of increased risk for some poor birth and maternal outcomes and should be considered in interventions aimed at improving the health of the mother and child.