184366 Unintended pregnancy and delayed entry into prenatal care (PNC), among Mexican women in Los Angeles County, CA

Wednesday, October 29, 2008: 1:40 PM

Karen M. Coller, MPH , Department of Population, Family, and Reproductive Health, Johns Hopkins School of Public Health, Baltimore, MD
Donna Strobino, PhD , Department of Population, Family, and Reproductive Health, Johns Hopkins School of Public Health, Baltimore, MD
Shin Margaret Chao, PhD, MPH , Maternal, Child, and Adolescent Health, Los Angeles County Department of Public Health, Los Angeles, CA
Michael C. Lu, MD, MPH , Department of Community Health Sciences, University of California Los Angeles School of Public Health, Los Angeles, CA
     
Unintended pregnancy may influence the timing of PNC access. Despite large numbers of Latina births, research addressing determinants of health behaviors during pregnancy among Latinas remains sparse. A population-based survey modeled after PRAMS, the Los Angeles Mommy and Baby Survey (LAMB), addresses determinants of unintended pregnancy as well as timely prenatal care. This study included 1214 Mexican women, 18-40 years old, who delivered live births in Los Angeles County in 2005. Unintended pregnancy included mistimed or unwanted births. PNC entry was categorized as timely (=<3 months) or late entry (>3 months). Logistic regression models estimated the effect of unintended pregnancy on delayed entry into PNC. US-Born women had the largest percentage of unintended births (48.3%). Among immigrants, there was an increasing trend with greater length of time in the US (p<0.05). Unintended pregnancy was also associated with high parity, younger age, lower income, lower education and not having a usual place for health care. Depression (OR= 2.10; CI: 1.66-2.66), lack of partner support (OR= 2.90; CI: 2.05-4.10), and greater stress (OR= 1.35; CI: 1.24-1.48) were psychosocial determinants. Unintended pregnancy was associated with delayed prenatal care entry (OR= 1.87; CI: 1.24-2.81) even after controlling for socio-demographic characteristics (AOR= 1.65; CI: 1.06-2.56). This association was reduced and no longer significant after adjustment for depression (AOR= 1.57; CI: 0.99-2.48) and lack of partner support (AOR= 1.54; CI: 0.97-2.44). The association of unintended pregnancy with timely entry into prenatal care among Mexican moms appears to be mediated through psychosocial determinants of use of care.

Learning Objectives:
1) Recognize unintended pregnancy as an important maternal health concern for Latina women 2)Describe potential pathways through which unintended pregnancy affects timely entry into prenatal care 3)Identify effective intervention strategies to both reduce unintended pregnancy among Mexican women and positively impact maternal behaviors

Keywords: Health Behavior, Immigrant Women

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I've worked on the LAMB project as part of my dissertation work for about 2 years now. I also hold an MPH in Epidemiology from the Univ of Michigan. My MPH thesis research focused on the reproductive health of Latinas both in San Francisco and the Central Valley of CA. Additional experience includes completing a fellowship at the CA State Maternal and Child Health Branch working on collaborative maternal mortality projects focusing on immigrant women in CA. I've also done research focusing on maternal health in Africa, in India looking at autonomy as a determinant of women's nutrition (manuscript drafted) and recently was a Johnson & Johnson Community Health Care Scholar at Johns Hopkins allowing me the opportunity to work on a community-based project addressing maternal behaviors during pregancy among teen moms in rural Florida.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Women’s health and Pregnancy
See more of: Maternal and Child Health