Trends and inequalities in unplanned pregnancy in three population-based birth cohorts in Pelotas, Brazil
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ORIGINAL ARTICLE
Trends and inequalities in unplanned pregnancy in three populationbased birth cohorts in Pelotas, Brazil Laı´sa Rodrigues Moreira1 • Fernanda Ewerling1,2 • Ina´ S. dos Santos1 • Fernando Ce´sar Wehrmeister1,2 • Alicia Matijasevich1,3 • Aluisio J. D. Barros1,2 • Ana M. B. Menezes1 • Helen Gonçalves1 • Joseph Murray1 • Marlos R. Domingues1 • Mariaˆngela Freitas Silveira1 Received: 23 March 2020 / Revised: 24 September 2020 / Accepted: 3 October 2020 Swiss School of Public Health (SSPH+) 2020
Abstract Objectives To assess time trends in unplanned pregnancy, stratified by sociodemographic status, reproductive history, and inequalities in family income and women’s skin color, in Pelotas, Brazil. Methods Data from mothers of participants of the 1993 (N = 5264), 2004 (N = 4243), and 2015 (N = 4268) Pelotas birth cohorts were analyzed. Unplanned pregnancy was investigated in the perinatal period, with tests to assess changes over time among different sociodemographic and reproductive history subgroups and inequalities as a function of family income and skin color. Results The prevalence of unplanned pregnancy was 62.7% (3299/ 5264), 65.9% (2794/ 4243), and 52.2% (2226/ 4268) in the 1993, 2004, and 2015 cohorts, respectively. Black or brown women and women of lower socioeconomic status had a higher prevalence of unplanned pregnancy in all cohorts. The overall rate of unplanned pregnancy decreased over time in most subgroups. Inequality as a function of family income and skin color increased during the time frame of assessment. Conclusions The prevalence of unplanned pregnancies decreased in the period analyzed, but it is still unjustifiably high. Efforts aimed at reducing unplanned pregnancy are vital and will require special attention to the most vulnerable groups. Keywords Unplanned pregnancy Family planning Reproductive health Socioeconomic factors Health inequalities
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00038-020-01505-0) contains supplementary material, which is available to authorized users. & Laı´sa Rodrigues Moreira [email protected]
Becoming a mother leads to many changes for women and their families. An unplanned pregnancy involves a host of implications for which the woman, her family, and her community are not always prepared (Gipson et al. 2008; Le Helen Gonc¸alves [email protected]
Fernanda Ewerling [email protected]
Joseph Murray [email protected]
Ina´ S. dos Santos [email protected]
Marlos R. Domingues [email protected]
Fernando Ce´sar Wehrmeister [email protected]
Mariaˆngela Freitas Silveira [email protected]
Alicia Matijasevich [email protected]
Extended author information available on the last page of the article
Aluisio J. D. Barros [email protected] Ana M. B. Menezes [email protected]
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L. R. Moreira et al.
et al. 2014). At an international level, the Sustainable Development Goals hi
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