Unintended pregnancies and maternal medical conditions: Insight into the Life Course Perspective from the 2007 Los Angeles County Mommy and Baby (LAMB) Project

BACKGROUND Nearly half of all pregnancies in the United States are unintended. With the growing trend in maternal and child health on the life course perspective, emphasis on family planning during the preconception period is requisite for a healthy pregnancy. We investigate the association between unintended pregnancies and maternal medical conditions in order to promote a healthy life course for mothers and children. METHODS We analyzed data from LAMB, a population-based survey with multi-level clustered sampling (n=6,264; 55% response rate), using SAS 9.2 and sampling weights to account for the complex sampling scheme. Mothers were asked if they had experienced any of a variety of medical conditions during their pregnancy, and these conditions were assessed individually by chi-squared and in aggregate by logistic regression. RESULTS Overall, Los Angeles County had a 53.4% prevalence of unintended pregnancies in 2007. Mothers with unintended pregnancies experienced significantly more pre-labor pain (17.7%, 14.3%), STDs (4.6%, 2.3%), bacterial vaginosis (15%, 11.9%), periodontal disease (20.1%, 17.3%), nausea (27.3%, 21.7%), and depression (24.8%, 13.8%). Unintended pregnancies were significantly related to maternal medical conditions during pregnancy in aggregate after controlling for maternal race, age, household income, educational status, and marital status (aOR: 1.2, p<.005). DISCUSSION Mothers with unintended pregnancies face a greater likelihood of experiencing medical conditions during pregnancy that can lead to unfavorable birth outcomes. Improving outcomes requires targeted interventions to reduce unintended pregnancies and maternal medical conditions, focusing the life course perspective on preconception health to address community and health care needs of mothers and children.