The prevalence of unintended pregnancy and its association with HIV status among pregnant women in South Africa, a national antenatal survey, 2019

To describe the prevalence of unintended pregnancy and its association with HIV status among pregnant women in South Africa. A cross-sectional survey was conducted between October and mid-November 2019 among pregnant women aged 15–49 years in 1589 selected public antenatal care facilities. Pregnancy intention was assessed using two questions from the London Measure of Unplanned Pregnancy. Survey logistic regression examined factors associated with unintended pregnancy. Among 34,946 participants, 51.6% had an unintended pregnancy. On multivariable analysis, the odds of unintended pregnancy was higher among women who knew their HIV-positive status before pregnancy but initiated treatment after the first antenatal visit (adjusted odds ratio [aOR], 1.5 [95% confidence interval (CI):1.2–1.8]), women who initiated treatment before pregnancy (aOR, 1.3 [95% CI:1.2–1.3]), and women with a new HIV diagnosis during pregnancy (aOR, 1.2 [95% CI:1.1–1.3]) compared to HIV-negative women. Women who were single, in a non-cohabiting or a cohabiting relationship, and young women (15–24 years) had significantly higher risk of unintended pregnancy compared to married women and women aged 30–49 years, respectively. A comprehensive approach, including regular assessment of HIV clients’ pregnancy intention, and adolescent and youth-friendly reproductive health services could help prevent unintended pregnancy.

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

Background: Maternal high-risk fertility behaviors have been linked to negative maternal and child health outcomes that include anaemia, undernutrition, and child mortality. In this context, we examined the association between maternal high-risk fertility behavior and pregnancy intention among women of reproductive age in Rwanda.Methods: This cross-sectional study is based on secondary data from the 2014–15 Rwanda Demographic and Health Survey (n=5661). The outcome of interest was pregnancy intention of the last child defined as intended or unintended. Maternal high-risk fertility behaviors were measured using maternal age at delivery, birth order, and birth interval. Chi-square test and multivariable regression models were performed. Results: The prevalence of unintended pregnancy was 46.8% (n=2652). Overall, 35.8% (n=2017) of women experienced single high-risk fertility behavior, while 23.1% (n=1282) of women experienced multiple high-risk fertility behaviors. Compared to women who have not experienced high-risk fertility behavior, the multivariable odds ratio (95% CI) of unintended pregnancy among women in single-risk and multiple-risk fertility behaviors were 2.00 (1.75, 2.28; p <0.001) and 2.49 (2.09, 2.95; p <0. 001.), respectively.Conclusion: Exposure to high-risk fertility behaviors is positively associated with unintended pregnancy among women in Rwanda. Therefore, reproductive and sexual health services should pay special attention to women who are <18 years or >34 years old; who have more than three children already; or have children with less than 24 months’ interval between giving birth.

Antecedents of Pregnancy Intention and Prenatal Father Engagement: A Dyadic and Typological Approach

Prior research indicates that unintended pregnancy is associated with poorer maternal well-being, decreased relationship stability, and compromised child health and development, whereas prenatal father engagement is linked to lower maternal stress and enhanced infant health. Here we extend such research, considering unintended pregnancy and prenatal father engagement in typological perspective to (1) identify different types of (prenatal) families; (2) explore whether problematic antecedent factors predict family type; and (3) whether family type forecasts postnatal parenting attitudes, father involvement, and marital conflict. Latent-class analysis using a subsample of participants from the Early Childhood Longitudinal Study-Birth Cohort ( n = 6100) revealed four types of families: High Pregnancy Intention/High Father Engagement (22.6%), Low Pregnancy Intention/High Father Engagement (14%), Average Pregnancy Intention/Average Father Engagement (58.2%), and Low Pregnancy Intention/Low Father Engagement (5.2%). Associational findings indicated having a highly involved father prenatally mitigates potential risks associated with an unintended pregnancy vis-à-vis family functioning.

Magnitude and Determinants of Antenatal Care Utilization in Kandahar City, Afghanistan

Background. Women’s and children’s health is a crucial public health concern that epitomizes the universal platform for Sustainable Development Goals (SDGs). Appropriate and timely care during pregnancy can improve maternal and child health. Objectives. The present study aimed at determining the magnitude and determinants of antenatal care services’ utilization in Kandahar city. Methods. A community-based cross-sectional study involving 850 women with at least one delivery in the last 2 years was carried out in Kandahar city from January to February 2021. Questionnaires to record information on sociodemographic, reproductive, and antenatal care- (ANC-) related characteristics were administered. Data were analyzed using SPSS 21.00 statistical software. We used descriptive statistics such as frequency and percentages to present the data. Determinants of antenatal care services’ utilization were determined using a multivariable logistic regression model. Results. Among all study participants, 589 (69.3%, 95% confidence interval (CI) = 66.0%–72.4%) of study participants utilized antenatal care services at least once. However, only 22% of the women were utilizing the recommended ≥4 ANC visits. Factors that remained significantly associated with antenatal care services’ utilization in multivariable analysis included women’s educational status (adjusted odds ratio (AOR) = 2.0, 95% CI: 1.0–4.3), pregnancy intention (AOR = 2.1, 95% CI: 1.1–3.4), and place of residence (AOR = 1.7, 95% CI: 1.1–2.6). Conclusion. This study has found high rates (vs. the national level) of antenatal care services’ utilization among women who had at least one delivery in the last 2 years. However, the rate of recommended ≥4 ANC visits was low. Factors determining antenatal care utilization such as educational status of the mother, pregnancy intention, and place of residence hold the key to address the issue of ANC services lower utilization and consequently improve maternal and fetal health.

ANALYSIS OF PREGNANCY INTENSION RISK FACTORS IN INDONESIA WITH DEMOGRAPHIC HEALTH SURVEY (DHS) IN 2017

The pregnancy intention can be divided into two, namely the desired pregnancy and unwanted pregnancy/Kehamilan Tidak Diinginkan (KTD). Unwanted pregnancy can cause negative impacts on the mother, such as not carrying out antenatal care (ANC) and abortion. Besides, babies born from KTD are more at risk of experiencing low birth weight and not getting breast milk/Air Susu Ibu (ASI) from their mothers. Therefore, the risk factors of pregnancy intention need to be known to prevent the incidence of KTD in Indonesia. This study analyzes the risk factors for pregnancy intention in Indonesia, such as maternal age, parity, sex of the baby born, mother's work status, education level, type of area of residence, family economy, and history of contraceptive use or family planning/Keluarga Berencana (KB). The research design was cross-sectional with analysis using logistic regression statistical tests. This study used secondary data from the 2017 Demographic Health Survey (DHS) with 14,778 subjects. The results of this analysis are the risk factors for pregnancy intention in Indonesia, namely the age of the mother (p-value = 0,000 and OR = 1.403), parity (p-value = 0,000 and OR = 2,860), the type of area of residence (p-value = 0,000 and OR = 1,518) and history of use of family planning (p-value = 0.000 and OR = 0.711). The risk of adverse events is greater in mothers aged <20 years and> 35 years, parity more than 3, residing in urban areas, and having a history of using family planning. There is no significant relationship between the sex of the baby, the mother's employment status, education level, and family economy on pregnancy intention.