196177 Pregnancy intention and breastfeeding duration: Comparing unwanted and mistimed pregnancies

Wednesday, November 11, 2009

Kaaren Nelson-Munson, BA , Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland, OR
Kenneth D. Rosenberg, MD, MPH , Office of Family Health, Oregon Public Health Division, Portland, OR
Rochelle Fu, PhD , Department of Public Health and Preventive Medicine, Oregon Health and Science University, Portland, OR
Elizabeth Adams, PhD, RD , Oregon Health and Sciences University, Portland, OR
Background: The most common categorization of pregnancy intendedness is “intended” versus “unintended.” Recent studies focus on the two categories of unintended pregnancy: mistimed and unwanted, questioning whether unwanted pregnancies are associated with worse outcomes than mistimed pregnancies.

Methods: The Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) is a population-based survey of Oregon mothers 2-6 months postpartum. Oregon PRAMS asks mothers whether, just before they got pregnant, they wanted to be pregnant then or sooner (“intended”), later (“mistimed”), or not at all (“unwanted”). PRAMS also asks mothers about how long they breastfed their infant. Multivariate logistic regression evaluated the association between pregnancy intendedness and breastfeeding for ≥8 weeks, while adjusting for the complex survey design features.

Results: Of 1915 respondents who had a live birth in 2005 (weighted response rate, 75.6%), 75.3% breastfed for ≥8 weeks. 62.1% reported intended pregnancy, 30.4% reported mistimed pregnancy and 7.5% reported unwanted pregnancy. Prevalence of breastfeeding ≥8 weeks was 81.4% (intended), 67.5% (mistimed), and 57.6% (unwanted). Compared to women with unwanted pregnancies (referent), mistimed pregnancies were significantly more likely to breastfeed ≥8 weeks (OR 1.99, 95% C.I.: 1.00-3.96).

Discussion: Women reporting their pregnancies as unwanted were significantly less likely to breastfeed ≥8 weeks compared to women reporting pregnancies as mistimed. This study suggests public health programs should focus limited resources on women who have unwanted pregnancies (7.5%) because they may be at greater risk for inferior outcomes than women with mistimed pregnancies (30.4%).

Learning Objectives:
Analyze a 3-category pregnancy intention variable and determine whether unwanted infants are less likely to be breastfed than mistimed infants. Assess whether breastfeeding resources might be more precisely directed to mothers at greatest risk. Identify risk factors associated with breastfeeding duration.

Keywords: Breastfeeding, Family Planning

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conceptualized the project, supervised the analysis, and supervised the discussion of the analysis
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.