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Health Equity/Community Health

Poster Session 2

(517) Factors associated with unintended pregnancy: A cross-sectional evaluation in a contemporary cohort

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective: Unintended pregnancy is associated with adverse birth outcomes. Recent restrictions on access to abortion make understanding factors associated with experiencing an unintended pregnancy especially important. Our objective was to understand the association between maternal demographic and socioeconomic factors and unintended pregnancy.

Study Design: This was a cross-sectional analysis of Pregnancy Risk Assessment Monitoring System (2016-2020) respondents with singleton live births. The primary outcome was unintended pregnancy (including respondents who reported they were ambivalent, had mistimed, or had undesired pregnancies). Multivariable models estimated the independent association between demographic and socioeconomic variables and unintended pregnancy. A conceptual framework based on the US Department of Health and Human Services Healthy People 2030 domains of social determinants of health was used to select variables. Secondary analyses examined these relationships in respondents with undesired pregnancy. All analyses were population weighted.

Results: The weighted population included 8.6 million respondents, of whom 40% reported unintended pregnancy including 6.2% with undesired pregnancy. Among demographic factors, young maternal age and non-Hispanic Black race had the highest association with unintended pregnancy (Table). Social/community and economic factors, including being unmarried, greater number of prior live births, greater number of dependents, Medicaid or lack of insurance, and lower income, were also significantly associated. Education of less than 12 years was associated with lower odds of unintended pregnancy. Similar associations were seen with undesired pregnancy with the addition of advancing maternal age.

Conclusion: Multiple demographic and socioeconomic factors that are markers for inequity and lower access to resources are associated with unintended pregnancy. Findings highlight populations that are vulnerable to the adverse consequences of unintended pregnancy, which is of particular importance in the era of restricted reproductive freedom.