Lida Moghaddam Banaem1, Fereshteh Majlessi. 1. Department of Midwifery, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. moghaddamb@modares.ac.ir
Abstract
OBJECTIVE: To compare 5-minute Apgar scores in newborns of wanted versus unwanted pregnancies. METHODS: This longitudinal cohort study included 1,800 pregnant women attending urban and rural health centres in southern Tehran for routine prenatal care. The subjects were divided into two equal groups as wanted and unwanted pregnancies and were followed up through their prenatal care to their delivery. Low Apgar was defined as a score of < 8. Various conditions thought to increase the risk of low Apgar were assessed by logistic regression. RESULTS: We found a prevalence of 0.4% (4 cases) for low 5' Apgar in wanted pregnancies and 1.7% (15 cases) in unwanted pregnancies. The difference between the two groups was significant (P value = 0.01). In logistic regression analysis, unwanted pregnancy status had a strong independent relationship with low Apgar, increasing the risk by 3-fold. The attributable risk in unwanted pregnancies was 0.54 (CI(0.95) = 0.13-0.81). CONCLUSIONS: In addition to the well-established maternal complications of unwanted pregnancy (e.g. emotional stress, illegal abortions, etc) it becomes clear that such pregnancies endanger the infant's health too. It is possible that many pregnant women, especially those with unwanted pregnancies, are not attending health centres for prenatal care. Further studies with active case finding are recommended to confirm these findings.
OBJECTIVE: To compare 5-minute Apgar scores in newborns of wanted versus unwanted pregnancies. METHODS: This longitudinal cohort study included 1,800 pregnant women attending urban and rural health centres in southern Tehran for routine prenatal care. The subjects were divided into two equal groups as wanted and unwanted pregnancies and were followed up through their prenatal care to their delivery. Low Apgar was defined as a score of < 8. Various conditions thought to increase the risk of low Apgar were assessed by logistic regression. RESULTS: We found a prevalence of 0.4% (4 cases) for low 5' Apgar in wanted pregnancies and 1.7% (15 cases) in unwanted pregnancies. The difference between the two groups was significant (P value = 0.01). In logistic regression analysis, unwanted pregnancy status had a strong independent relationship with low Apgar, increasing the risk by 3-fold. The attributable risk in unwanted pregnancies was 0.54 (CI(0.95) = 0.13-0.81). CONCLUSIONS: In addition to the well-established maternal complications of unwanted pregnancy (e.g. emotional stress, illegal abortions, etc) it becomes clear that such pregnancies endanger the infant's health too. It is possible that many pregnant women, especially those with unwanted pregnancies, are not attending health centres for prenatal care. Further studies with active case finding are recommended to confirm these findings.
Authors: K C Ashish; Mats Målqvist; Johan Wrammert; Sheela Verma; Dhan Raj Aryal; Robert Clark; P K C Naresh; Ravi Vitrakoti; Kedar Baral; Uwe Ewald Journal: BMC Pediatr Date: 2012-10-05 Impact factor: 2.125