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Maternal and Child Health Journal
Published in: Maternal and Child Health Journal 3/2017

Open Access 01-03-2017 | Review Paper

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

Authors: Jennifer A. Hall, Lorna Benton, Andrew Copas, Judith Stephenson

Published in: Maternal and Child Health Journal | Issue 3/2017

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Abstract

Introduction Previous systematic reviews concluded that rigorous research on the relationships between pregnancy intentions and pregnancy outcomes is limited. They further noted that most studies were conducted in high-income countries and had methodological limitations. We aim to assess the current evidence base for the relationship between pregnancy intention and miscarriage, stillbirth, low birthweight (LBW) and neonatal mortality. In March 2015 Embase, PubMed, Scopus and PsychInfo were searched for studies investigating the relationship between pregnancy intention and the outcomes of interest. Methods Studies published since 1975 and in English, French or Spanish were included. Two reviewers screened titles and abstracts, read the full text of identified articles and extracted data. Meta-analyses were conducted where possible. Results Thirty-seven studies assessing the relationships between pregnancy intention and LBW were identified. A meta-analysis of 17 of these studies found that unintended pregnancies are associated with 1.41 times greater odds of having a LBW baby (95%CI 1.31, 1.51). Eight studies looking at miscarriage, stillbirth or neonatal death were found. The limited data concerning pregnancy loss and neonatal mortality precluded meta-analysis but suggest these outcomes may be more common in unintended pregnancies. Discussion While there seems to be an increased risk of adverse pregnancy outcome in unintended pregnancies, there has been little improvement in either the quantity of evidence from low-income countries or in the quality of evidence generally. Longitudinal studies of pregnancy intention and pregnancy outcome, where pregnancy intention is assessed prospectively with a validated measure and where analyses include confounding or mediating factors, are required in both high- and low-income countries.
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Footnotes
1
They defined perinatal mortality as deaths from 4 months of pregnancy to 28 days after birth.
 
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Metadata
Title
Pregnancy Intention and Pregnancy Outcome: Systematic Review and Meta-Analysis
Authors
Jennifer A. Hall
Lorna Benton
Andrew Copas
Judith Stephenson
Publication date
01-03-2017
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 3/2017
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-016-2237-0

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