Clustering of characteristics associated with unplanned pregnancies: The generation R study

Clair A. Enthoven, Hanan El Marroun, M. Elisabeth Koopman-Verhoeff, Wilma Jansen, Mijke P. Lambregtse-van den Berg, Frouke Sondeijker, Manon H.J. Hillegers, Hilmar H. Bijma, Pauline W. Jansen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)
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Background: Unplanned or unintended pregnancies form a major public health concern because they are associated with unfavorable birth outcomes as well as social adversity, stress and depression among parents-to-be. Several risk factors for unplanned pregnancies in women have previously been identified, but studies usually take a unidimensional approach by focusing on only one or few factors, disregarding the possibility that predictors might cluster. Furthermore, data on predictors in men are largely overlooked. The purpose of this study is to determine predictors of unplanned versus planned pregnancy, to determine predictors of ambivalent feelings regarding pregnancy, and to investigate how characteristics of men and women with an unplanned pregnancy cluster together. Methods: This study was embedded in Generation R, a multiethnic population-based prospective cohort from fetal life onwards. Pregnancy intention was reported by 7702 women and 5367 partners. Information on demographic, mental, physical, social, and sexual characteristics was obtained. Logistic regression, multinomial regression and cluster analyses were performed to determine characteristics that were associated with an unplanned pregnancy, with ambivalent feelings regarding the unplanned pregnancy and the co-occurrence of characteristics in women and men with unplanned pregnancy. Results: Twenty nine percent of the pregnancies were unplanned. Logistic regression analyses showed that 42 of 44 studied predictors were significantly associated with unplanned pregnancy. The most important predictors were young age, migration background, lower educational level, lower household income, financial difficulties, being single, lower cognitive ability, drug use prior to pregnancy, having multiple sexual partners in the year prior to the pregnancy, younger age of first sexual contact and a history of abortion. Multinomial regression analyses showed that a Turkish or Moroccan background, Islamic religion, little financial opportunities, being married, having ≥3 children, high educational level, more mental health and social problems and older age of first sexual contact were associated with prolonged ambivalent feelings regarding pregnancy. Different combinations of characteristics were observed in the four clusters of women and men with unplanned pregnancy. Conclusions: Many predictors are related with unplanned pregnancies, ambivalent feelings toward the pregnancy, and we identified very heterogeneous groups of women and men with unplanned pregnancies. This calls for heterogeneous measures to prevent unplanned pregnancies.

Original languageEnglish
Article number1957
JournalBMC Public Health
Issue number1
Publication statusPublished - 24 Oct 2022

Bibliographical note

Funding Information:
The general design of the Generation R Study is made possible by financial support from the Erasmus Medical Center and the Erasmus University Rotterdam, the Netherlands Organization for Health Research and Development (ZonMW), the Netherlands Organisation for Scientific Research (NWO), the Ministry of Health, Welfare and Sport and the Ministry of Youth and Families. The current study was made possible by a grant from the Netherlands Organization for Health Research and Development (ZonMw Unintended Pregnancy Research Program, grant number 554002008 to PWJ). HM was supported by Stichting Volksbond Rotterdam, NWO Aspasia grant (No. 015.016.056), Brain and Behavior Research Foundation: NARSAD Young Investigator Grant, (Award Number: 27853); and European Union’s Horizon 2020 research and innovation programme (grant agreement No.733206 LifeCycle). HB was supported by a grant from the Netherlands Organization for Health Research and Development (ZonMw Unintended Pregnancy Research Program, grant number 554001014). FS was supported by the same ZonMw Program, grant number 554002002. The funders had no role in the design and conduct of the study or the writing of the report.

Publisher Copyright: © 2022, The Author(s).


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