com-Unintended and Low Birthweight in Ecuador

Objectives. This study assessed the relationship between unintended pregnancy and infant birthweight in Ecuador, differentiating between unwanted and mistimed pregnancies. Methods. Analyses focused on a subsample of women (n = 2490) interviewed in the 1994 Ecuador Demographic and Maternal–Child Health Survey. Logistic regression was used to assess the relationship between pregnancy intention status and low birthweight after control for other factors. Results. Infants from unwanted pregnancies were more likely than infants from planned pregnancies to have low birthweight (odds ratio=1.64, 95% confidence interval=1.22, 2.20). Mistimed pregnancy was not associated with low birthweight. Conclusions. Unwanted pregnancy, but not mistimed pregnancy, is associated with low birthweight in Ecuador. Further research is needed to understand the mechanism through which pregnancy intention status affects birthweight. (Am J Public Health. 2001;91:808–810) At the time of the study, Elizabeth Eggleston was a doctoral candidate in, and Milton Kotelchuck was with, the Department of Maternal and Child Health, University of North Carolina at Chapel Hill. Amy Ong Tsui is with the Department of Maternal and Child Health and the Carolina Population Center, University of North Carolina at Chapel Hill. Requests for reprints should be sent to Elizabeth Eggleston, DrPH, Population Leadership Program, 2168 Shattuck Ave, Suite 300, Berkeley, CA 94704 (e-mail: eeggleston@hotmail.com). This brief was accepted August 10, 2000. Recent research suggests that infants from unintended pregnancies may be at a greater risk of low birthweight than infants from planned pregnancies. A US study that examined the separate impacts of unwanted (unintended, in women not wanting more children), mistimed (unintended, in women desiring a child in the future), and planned (intended) pregnancies revealed that infants from unwanted but not mistimed pregnancies were slightly more likely than infants from planned pregnancies to be of low birthweight. When maternal behaviors such as cigarette smoking were added to the model, however, unwanted pregnancy was no longer a significant predictor of low birthweight in that study. A study of first births to US women aged 18 to 26 years revealed no difference in the prevalence of low birthweight between infants from unintended pregnancies (a combined category of unwanted and mistimed) and those from planned pregnancies. However, another US study showed that intrauterine growth retardation was significantly more likely among infants from unintended pregnancies (unwanted and mistimed combined) than among infants from planned pregnancies. A literature search located only 1 published study on unintended pregnancy and low birthweight that included women from developing countries. The study showed that among users of natural family planning in 4 countries (Colombia, Italy, the United States, and Chile), no significant difference in low birthweight existed between infants from unintended pregnancies (unwanted and mistimed pregnancies combined) and infants from planned pregnancies. Findings were not presented by study site, so it is unclear whether an association between pregnancy intention status and low birthweight was absent in all countries. The purpose of this study was to assess the relationship between unintended pregnancy and infant birthweight in Ecuador, differentiating between unwanted and mistimed pregnancies.