Intention to Become Pregnant and Low Birth Weight and Preterm Birth: A Systematic Review

@article{Shah2009IntentionTB,
  title={Intention to Become Pregnant and Low Birth Weight and Preterm Birth: A Systematic Review},
  author={Prakesh S. Shah and Taiba Balkhair and Arne Ohlsson and Joseph Beyene and Fran Scott and Corine Frick},
  journal={Maternal and Child Health Journal},
  year={2009},
  volume={15},
  pages={205-216}
}
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… 

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Women with unintended pregnancies are at increased risk of producing LBW babies and experiencing complications during pregnancy, and maternal pregnancy intention should be addressed in interventions aimed to reduce maternal and child morbidity and mortality.

Comparison of pregnancy complications in unintended and intended pregnancy: A prospective follow-up study

The findings of this study indicated that unintended pregnancy can be a risk factor for pregnancy complications including preeclampsia and low birth weight and that sophisticated monitoring should be performed for better management of these complications.

Pregnancy Intention and Pregnancy Outcome: Systematic Review and Meta-Analysis

There seems to be an increased risk of adverse pregnancy outcome in unintended pregnancies and there has been little improvement in either the quantity of evidence from low-income countries or in the quality of evidence generally.

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Higher risk of cesarean section and inappropriate weight gain during pregnancy as adverse outcomes of unintended pregnancy in adjusted model is found.

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In this systematic review and meta-analysis of epidemiologic observational studies relevant to US populations, unintended pregnancy, compared with intended pregnancy, was significantly associated with adverse maternal and infant outcomes.

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Pregnancies that were less planned were associated with women of lower socio-economic status (SES), an unhealthier lifestyle before and during the pregnancy, more stress, and less social support.

Short interpregnancy interval and poor fetal growth: Evaluating the role of pregnancy intention

Findings suggest that previously observed associations between short interpregnancy interval and lower birthweight may reflect confounding by socio‐economic and/or other unmeasured confounders.

Psychiatric vulnerability and the risk for unintended pregnancies, a systematic review and meta-analysis

The findings suggest an increased risk of UPs in women with psychiatric vulnerability, which is a global health problem as they contribute to adverse maternal and offspring outcomes, which underscores the need for prevention.

Research : Pregnancy Effect of pregnancy planning on maternal and neonatal outcomes in women with Type 1 diabetes

Outcomes did not differ between the groups in relation to pre-eclampsia, congenital malformations or a composite adverse outcome, indicating women with Type 1 diabetes are fully aware of the risks associated with diabetes in pregnancy.

Effects of pregnancy planning on maternal and neonatal outcomes in women with type 1 diabetes

Outcomes did not differ between the groups in relation to pre-eclampsia, congenital malformations or a composite adverse outcome, and risks associated with diabetes in pregnancy need to be highlighted to all women, their partners and families, and healthcare professionals.
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References

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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.

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In unadjusted results, pregnancy intention was associated with preterm birth among both whites and immigrant Latinas, but not among blacks or U.S.-born Latinas.

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Contrary to the hypothesis, an intended pregnancy at a young age was associated with a higher risk of poor birth outcomes.

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In this study of a cohort of urban, clinic-attending, low-income, pregnant black women, unintended pregnancy had a statistically significant association with preterm birth.

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Pregnancy intendedness remains an important concept in the reproductive health literature integrally tied to indicators of maternal mental health, but not necessarily to pregnancy outcomes.

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Knowing the planning status of a pregnancy can help identify women who may need support to engage in prenatal behaviors that are associated with healthy outcomes and appropriate infant care.

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Mothers of very low birth weight infants were significantly more likely than those who had a normal-weight baby to report that they had felt unhappy about the pregnancy, and odds ratios associating these two unwantedness categories with low-birth-weight babies were higher among Medicaid recipients than among women not receiving Medicaid.

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Prenatal care programs should focus on known risk factors for intrauterine growth restriction, and research should continue to explore associations between psychosocial factors and IUGR.