Black, Kirsten I;
Dorney, Edwina;
Hall, Jennifer A;
Pelosi, Marilena;
Khan, Saleem Ahmed;
Cheney, Kate;
(2023)
Using a validated instrument to assess pregnancy planning and preconception care at antenatal booking visits:
a retrospective cohort study.
Medical Journal of Australia
10.5694/mja2.52109.
(In press).
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Abstract
Objective: To determine the completion rate for the London Measure of Unplanned Pregnancy (LMUP), a psychometrically validated measure of a woman's intention with regard to a current or recent pregnancy, during booking visits at two metropolitan antenatal care clinics; to identify socio-demographic characteristics associated with unplanned pregnancy. // Design, setting, participants: Retrospective cohort study; analysis of LMUP data for women attending antenatal care booking consultations as public patients in the Sydney Local Health District, 31 December 2019 – 30 November 2020. // Main outcome measures: Proportions of women with LMUP scores indicating unplanned (0–9) or planned pregnancies (10–12); associations between planned pregnancy and socio-demographic characteristics, crude and adjusted for age, parity, and socio-economic status (Index of Relative Socioeconomic Disadvantage). // Results: Of 4993 women with antenatal care bookings, the LMUP was completed by 2385 (47.8%; 1142 of 3564 women at the tertiary referral hospital [32.0%], 1118 of 1160 at the secondary hospital [96.3%]). Planned pregnancies were indicated by the total LMUP scores of 1684 women (70.6%); 1290 women (59.1%) reported no health actions in preparation for pregnancy. In multivariable analyses, planned pregnancies were more likely in all age groups than for women aged 24 years or younger (30–34 years: adjusted odds ratio [aOR], 2.54; 95% confidence interval [CI], 1.76–3.66; 35–39 years: aOR, 2.91; 95% CI, 1.95–4.33). The likelihood of planned pregnancy declined with increasing parity (v no previous births: three previous births: aOR, 0.25; 95% CI, 0.16–0.40; four or more previous births: aOR, 0.10; 95% CI, 0.05–0.19). // Conclusion: Seven in ten women who completed the LMUP had planned their pregnancies, but fewer than half had undertaken health-related actions prior to conceiving. Higher parity was associated with unplanned pregnancy, indicating the importance of postpartum contraception advice. Overcoming barriers to implementing the LMUP more widely would enhance preconception health monitoring.
| Type: | Article |
|---|---|
| Title: | Using a validated instrument to assess pregnancy planning and preconception care at antenatal booking visits: a retrospective cohort study |
| Location: | Australia |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.5694/mja2.52109 |
| Publisher version: | https://doi.org/10.5694/mja2.52109 |
| Language: | English |
| Additional information: | Copyright © 2023 The Authors. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd. This is an open access article under the terms of the Creative Commons Attribution License, https://creativecommons.org/licenses/by/4.0/, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Pregnancy; Contraception; Maternal health; Postpartum |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL EGA Institute for Womens Health > Reproductive Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10177826 |
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