Discordant pregnancy intentions in couples and rapid repeat pregnancy
Discordant pregnancy intentions in couples and rapid repeat pregnancy
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DOI：
10.1016/j.ajog.2015.10.149
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发表时间：
2016-04-01
影响因子：
9.8
通讯作者：
Masho, Saba W.
中科院分区：
文献类型：
--
作者：
Cha, Susan;Chapman, Derek A.;Masho, Saba W.
背景：快速重复妊娠（RRP）是美国的一个主要问题。很少有研究探讨伴侣协议对怀孕意愿和 RRP 的影响。 目的：我们试图研究美国女性夫妇怀孕意愿和 RRP 之间的关系。研究设计：数据来自 2006 年至 2010 年全国家庭成长调查。包括在第二次怀孕前与 1 位丈夫/伴侣同居的经产妇女（N = 3463）。结果 RRP 被归类为在第一次怀孕解决后 24 个月内经历第二次怀孕，或从第一次怀孕解决后 24 个月内经历第二次怀孕。母亲和父亲的怀孕意向分为 4 组：均意向 (M+P+)；母亲有意的和父亲无意的 (M+P-)；母亲无意的和父亲有意的 (M-P+)；都是无意的（M-P-）。进行多元逻辑回归以确定夫妇怀孕意愿与 RRP 之间的关联。结果：近一半 (49.4%) 的女性有 RRP。大约 15% 的受访者表示夫妻怀孕意图不一致，22% 的受访者表示母亲和父亲无意。与双方都打算怀孕的夫妇 (M+P+) 相比，当父亲打算怀孕但母亲不打算怀孕时，RRP 的几率较高（调整后优势比，2.51；95% 置信区间，1.45-4.35）；如果父亲不打算怀孕，但母亲打算怀孕，则 RRP 几率较低（调整后优势比，0.77；95% 置信区间，0.70-0.85）。一致的夫妻怀孕意向（M-P- 与 M+P+）之间没有观察到差异。结论：研究结果强调了父亲意向在生育决策中的重要作用。研究结果表明，RRP 受到父亲而非母亲怀孕意愿的强烈影响。临床医生和公共卫生工作者应让合作伙伴参与计划生育讨论和最佳生育间隔咨询。
BACKGROUND: Rapid repeat pregnancy (RRP) is a major problem in the United States. Few studies have explored the influence of partner agreement on pregnancy intention and RRP.OBJECTIVE: We sought to examine the association between couple pregnancy intentions and RRP among women in the United States.STUDY DESIGN: Data came from the 2006 through 2010 National Survey of Family Growth. Multiparous women who cohabited with 1 husband/partner before conception of second pregnancy were included (N = 3463). The outcome, RRP, was categorized as experiencing a second pregnancy within 24 months of the first pregnancy resolution, or >= 24 months from the first pregnancy resolution. Maternal and paternal pregnancy intentions were categorized into 4 dyads: both intended (M+P+); maternal intended and paternal unintended (M+P-); maternal unintended and paternal intended (M-P+); and both unintended (M-P-). Multiple logistic regression was conducted to determine the association between couple pregnancy intentions and RRP.RESULTS: Nearly half (49.4%) of women had RRP. Approximately 15% of respondents reported discordant couple pregnancy intentions and 22%, maternal and paternal unintendedness. Compared to couples who both intended their pregnancy (M+P+), the odds of RRP was higher when fathers intended pregnancy but not mothers (adjusted odds ratio, 2.51; 95% confidence interval, 1.45-4.35) and lower if fathers did not intend pregnancy but mothers did (adjusted odds ratio, 0.77; 95% confidence interval, 0.70-0.85). No difference was observed between concordant couple pregnancy intentions (M-P- vs M+P+).CONCLUSION: Findings highlight the important role of paternal intention in reproductive decisions. Study results suggest that RRP is strongly influenced by paternal rather than maternal pregnancy intentions. Clinicians and public health workers should involve partners in family planning discussions and counseling on optimal birth spacing.