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Reassessing pregnancy intention and its relation to maternal, perinatal and neonatal outcomes in a low-income setting: A cohort study
- Source :
- PLoS ONE, Vol 13, Iss 10, p e0205487 (2018), PLoS ONE
- Publication Year :
- 2018
- Publisher :
- Public Library of Science (PLoS), 2018.
-
Abstract
- Background It is unclear whether unintended pregnancies are associated with adverse outcomes. Data are predominantly from high-income countries and have methodological limitations, calling the findings into question. This research was designed to overcome these limitations and assess the relationships between pregnancy intention and miscarriage, stillbirth, low birthweight, neonatal death and postnatal depression in a low-income country. Methods The pregnancy intention of 4,244 pregnant women in Mchinji District, Malawi, was measured using the validated Chichewa version of the London Measure of Unplanned Pregnancy (LMUP). Women were re-interviewed postnatally to assess pregnancy outcome. Postnatal depression was assessed using the WHO’s Self-Reporting Questionnaire. Multivariable regressions were conducted, with the choice of confounders informed by a pre-existing conceptual epidemiological hierarchy. Results Planned pregnancies are associated with a reduced risk of any (adjusted RR 0.90 [95%CI 0.86, 0.95]) or high symptoms of depression (adjusted RR 0.76 [95%CI 0.63, 0.91]) compared to unplanned pregnancies in rural Malawi. There was no relationship between pregnancy intention and the composite measure of miscarriage, stillbirth, low birthweight and neonatal death. There was some evidence that greater pregnancy intention was associated with reduced adjusted risk of stillbirth (0·93 [95%CI 0·87, 1·00]). Conclusion Our study is the first to use a psychometrically valid measure of pregnancy intention, and to do so antenatally. As pregnancy intention increases, the risk of postnatal depression and, possibly, stillbirth decreases. This suggests a new, clinical use for the LMUP; identifying women antenatally who are at risk of these adverse pregnancy outcomes.
- Subjects :
- Male
Malawi
Psychometrics
Adolescent
Physiology
Maternal Health
Perinatal Death
Social Sciences
lcsh:Medicine
Miscarriage
Geographical Locations
Cohort Studies
Depression, Postpartum
Pregnancy
Mental Health and Psychiatry
Medicine and Health Sciences
Birth Weight
Psychology
Humans
lcsh:Science
Poverty
Mood Disorders
Depression
Body Weight
lcsh:R
Infant, Newborn
Pregnancy Outcome
Obstetrics and Gynecology
Biology and Life Sciences
Neonates
Pregnancy, Unplanned
Infant, Low Birth Weight
Stillbirth
Pregnancy Complications
Abortion, Spontaneous
Physiological Parameters
People and Places
Africa
Women's Health
Female
lcsh:Q
Self Report
Stillbirths
Research Article
Developmental Biology
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 13
- Issue :
- 10
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.pmid.dedup....e90e898dbbf2e48022bcd4510cc88895