Intention to Become Pregnant and Low Birth Weight and Preterm Birth: A Systematic Review
Intention to Become Pregnant and Low Birth Weight and Preterm Birth: A Systematic Review
复制标题
DOI：
10.1007/s10995-009-0546-2
复制
发表时间：
2011-02-01
影响因子：
2.3
通讯作者：
Frick, Corine
中科院分区：
文献类型：
--
作者：
Shah, Prakesh S.;Balkhair, Taiba;Frick, Corine
增加的压力、心理社会问题、经济劣势和缺乏产前护理被认为是意外怀孕结局差异的原因。关于母亲意愿和妊娠结局的研究得出了不同的结果。目的回顾低出生体重(LBW)/早产(PTB)与意外妊娠导致活产相关风险的研究。我们回顾了来自Medline、Embase、CINAHL的关于产妇意图和结局的研究，以及确定的文章的书目。意外怀孕还被进一步归类为不合时宜(当时不是有意的)或意外(任何时候都不想要)。报告怀孕意向和任何结果之间的关联的研究被包括在内。研究质量在选择、暴露评估、混杂因素调整、分析、结果评估和自然损耗方面进行了偏差评估。来自纳入研究的未调整和调整后的数据由两位评价者提取。意外妊娠中发生LBW的几率显著增加[优势比(OR)1.36，95%可信区间(CI)1.25，1.48]。在意想不到的类别中，错误的怀孕时间(OR 1.31，95%CI 1.13，1.52)和意外怀孕(OR 1.51，95%CI 1.29，1.78)与LBW相关。意外妊娠(OR 1.31，95%CI 1.09，1.58)和意外妊娠(OR 1.50，95%CI 1.41，1.61)发生肺结核的风险显著增加，但不适时妊娠(OR 1.36，95%CI 0.96，1.93)无统计学意义。意外、意外和不合时宜的怀孕终止于活产与LBW和PTB的风险显著增加相关。
Increased stress, psychosocial problems, economic disadvantages, and lack of prenatal care are proposed to explain discrepancies in the outcome of unintended pregnancies. Studies of maternal intention and pregnancy outcomes have yielded varied results. Objective is to review studies of the risk of low birth weight (LBW)/preterm births (PTB) associated with unintended pregnancies ending in a live birth. We reviewed studies reporting on maternal intentions and outcomes from Medline, Embase, CINAHL, and bibliographies of identified articles. An unintended pregnancy was further classified as mistimed (not intended at that time) or unwanted (not desired at any time). Studies reporting an association between pregnancy intention and any of the outcomes were included. Study quality was assessed for biases in selection, exposure assessment, confounder adjustment, analyses, outcomes assessment, and attrition. Unadjusted and adjusted data from included studies were extracted by two reviewers. There were significantly increased odds of LBW among unintended pregnancies [odds ratio (OR) 1.36, 95% confidence interval (CI) 1.25, 1.48] ending in a live birth. Within the unintended category, mistimed (OR 1.31, 95% CI 1.13, 1.52) and unwanted (OR 1.51, 95% CI 1.29, 1.78) pregnancies were associated with LBW. There were statistically significantly increased odds of PTB among unintended (OR 1.31, 95% CI 1.09, 1.58), and unwanted (OR 1.50, 95% CI 1.41, 1.61) but not for mistimed (OR 1.36, 95% CI 0.96, 1.93) pregnancies. Unintended, unwanted, and mistimed pregnancies ending in a live birth are associated with a significantly increased risk of LBW and PTB.