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.
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Funding
We are grateful for financial support received from several sources. In part, this study was financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001. This article is based on data from the 1993, 2004 and 2015 Pelotas birth cohort studies, conducted at the Postgraduate Program in Epidemiology at the Universidade Federal de Pelotas, with the collaboration of the Brazilian Public Health Association (ABRASCO). The European Union, National Support Program for Centers of Excellence (PRONEX), the Brazilian National Research Council (CNPq), and the Brazilian Ministry of Health supported previous phases of the 1993 Pelotas birth cohort. The World Health Organization, National Support Program for Centers of Excellence (PRONEX), Brazilian National Research Council (CNPq), Brazilian Ministry of Health, and Children’s Pastorate supported previous phases of the 2004 Pelotas birth cohort. The first phases of the 2015 Pelotas (Brazil) birth cohort were funded by the Wellcome Trust (095582).
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All procedures performed in this study were in accordance with the legislation in force at the time of assessment and with the 1964 Declaration of Helsinki and its later amendments. Informed consent was obtained from all individual participants included in the study, and confidentiality of data was ensured throughout process. In cases in which the participants were younger than 18 years old, informed consent from their parents or legally authorized representative was required. In Brazil, Ethics Committee submission and approval only became mandatory in 1996; thus, the 1993 cohort was not subject to such requirements. The 2004 and 2015 Pelotas birth cohorts were approved by the Universidade Federal de Pelotas Research Ethics Committees. The 2004 cohort was accepted by the Ethics Committee of the School of Medicine, and the 2015 cohort, by the Ethics Committee of the School of Physical Education.
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Moreira, L.R., Ewerling, F., dos Santos, I.S. et al. Trends and inequalities in unplanned pregnancy in three population-based birth cohorts in Pelotas, Brazil. Int J Public Health 65, 1635–1645 (2020). https://doi.org/10.1007/s00038-020-01505-0
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DOI: https://doi.org/10.1007/s00038-020-01505-0