Pregnancy Outcomes by Pregnancy Intention in a Managed Care Setting
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Objectives Published studies show poor pregnancy outcomes associated with unintended pregnancies are disproportionately higher than in planned pregnancies and place a burden on the health care system. This study was designed to compare pregnancy intention rates, compare sociodemographic characteristics of women by pregnancy intention and compare pregnancy outcomes in a managed care setting. Methods A large managed health care organization in California conducted a retrospective medical record review of 1,784 women seeking prenatal care in 2002 to learn how women self-reported their pregnancy intention, compare pregnancy intention rates between this health plan to the national data, and to compare antecedents and pregnancy outcomes based on pregnancy intention. Results Overall, 62.1% of pregnancies were self-reported as intended with 26.4% mistimed and 11.4% unwanted. Being young, single, having lower educational attainment, having other living children, consuming alcohol and being a woman of color were the greatest predictors of having an unintended pregnancy. Despite these predictors, birth outcomes for unintended pregnancies in this setting showed no statistical difference from planned pregnancies. Conclusion Awareness of pregnancy intention of the women who are at greatest risk may be an important contributor to improving birth outcomes and health plan decisions about reproductive care services. Early entry to prenatal care and integrated services that decrease substance abuse and support high-risk pregnancy management are important contributors to reducing poor pregnancy outcomes.
KeywordsPregnancy intention Prenatal care Pregnancy outcomes
This work was supported by Veronica Osejo, Early Start Project Manager, Kaiser Permanente, Northern California.
- 1.Henshaw, S. K. (1998). Unintended pregnancy in the United States. Family Planning Perspectives, 30, 24–29. 46.Google Scholar
- 2.Finer, L. B., & Henshaw, S. K. (2006). Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspectives on Sex and Reproductive Health, 38 (2), 92.Google Scholar
- 3.CDC. (2002). Safe motherhood: Promoting health for women before, during and after pregnancy. Washington, DC: U.S. Department of Health and Human Services.Google Scholar
- 5.Pallitto, C. C., & O’Campo, P. (2004). The relationship between intimate partner violence and unintended pregnancy: Analysis of a national sample from Columbia. International Family Planning Perspectives, 30(4), 165–173: available at: http://www.guttmacher.org/pubs/journals/3016504.html. Accessed 6 Nov 2008.
- 6.Chernova, Y. Government pushes doctors to begin pregnancy care long before conception, Wall St. Journal, May 16, 2006; http://online.wsj.com/article/SB114773556689853512.html. Accessed 15 March 2007.
- 7.Gordon, N. P. (2002). Kaiser Permanente Member Health Survey http://dor-ent1.kaiser.org/dor/mhsnet/pdf_02/mhs02reg_e.pdf. Accessed 1 June 2006.
- 8.2002 National Survey of Family Growth, Cycle 6, Center for Disease Control, National Center for Health Statistics; http://www.cdc.gov/nchs/nsfg.htm.
- 11.Healthy People 2010 Objectives, Maternal Infant and Child Health. Center for Disease Control and Prevention, Health Resources Services Administration; http://www.healthypeople.gov/Document/pdf/Volume2/16MICH.pdf.
- 12.Kaiser Permanente. Northern California, Health Plan Employer Data and Information Set (HEDIS), Quality Operational Support, http://kpnet.kp.org/california/tpmg/qos/QADemo/HEDIS.html.
- 13.Healthy California 2010, last updated 4/24/2008, California Department of Public Health; http://ww2.cdph.ca.gov/data/indicators/goals/Pages/FA16.aspx. Accessed 10 Nov 2008.
- 14.Kaiser Family Foundation. 2004 data KFF state facts abstracted 12/6/06 www.statefacts.org.
- 15.Crites, Y., et al. (2005). Managing high-risk obstetric cases and analyzing neonatal outcome: The KP Northern California Regional Perinatal Service Center. The Permanente Journal, 9(1), 37–40.Google Scholar