Maternal and Child Health Journal

, Volume 15, Issue 2, pp 205–216 | Cite as

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

  • Prakesh S. Shah
  • Taiba Balkhair
  • Arne Ohlsson
  • Joseph Beyene
  • Fran Scott
  • Corine Frick
Article

Abstract

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.

Keywords

Low birth weight Preterm birth Unintended pregnancy 

Abbreviations

LBW

Low birth weight

PTB

Preterm birth

SGA

Small for gestational age

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Prakesh S. Shah
    • 1
    • 2
    • 4
  • Taiba Balkhair
    • 1
    • 2
  • Arne Ohlsson
    • 1
    • 2
    • 3
    • 4
  • Joseph Beyene
    • 5
    • 6
  • Fran Scott
    • 6
    • 7
  • Corine Frick
    • 8
    • 9
  1. 1.Department of PaediatricsMount Sinai HospitalTorontoCanada
  2. 2.Department of PaediatricsUniversity of TorontoTorontoCanada
  3. 3.Department of Obstetrics and GynaecologyUniversity of TorontoTorontoCanada
  4. 4.Department of Health Policy, Management and EvaluationUniversity of TorontoTorontoCanada
  5. 5.Research Institute of the Hospital for Sick ChildrenUniversity of TorontoTorontoCanada
  6. 6.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  7. 7.Toronto Public HealthTorontoCanada
  8. 8.Alberta Perinatal Health ProgramUniversity of CalgaryCalgaryCanada
  9. 9.Faculty of NursingUniversity of CalgaryCalgaryCanada

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