Abstract clinics was (12.3%) and majority (53.1%) found

 

Abstract

 

Purpose:
To identify the prevalence of unplanned pregnancy and the
most common associated factors that might increase the incidence along with
psychological effect.

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Material
and methods: Self-administrated survey was
conducted among pregnant women attending obstetric clinics during January,
February and March 2017 at King Khalid university hospitals. Of whom 358
answered the survey. SPSS version 22 was used for completed and partial
completed survey entry and analysis.

 

 

Result:
Prevalence of unplanned pregnancy among pregnant women
attending the clinics was (12.3%) and majority (53.1%) found to be planned. We
found that there were specific significant factors (age, gravidity and parity)
which could play a role in determining the pregnancy was either planned or
unplanned. Unplanned pregnancy associated with minimal psychological effect or
distress when compared to planned pregnancy found when applied a screening
test.

 

Conclusion:
Unplanned pregnancy has been associated with poor
outcomes to the mother and baby along with psychological effect. Increasing the
level of awareness and identifying the role of contraception in preventing
unplanned pregnancy need to be conducted.

 

 

 

Key
words: unplanned pregnancy, psychological effect

 

 

 

 

Introduction

Unintended pregnancy is a general term that used to describe
unplanned, mistimed and unwanted pregnancies.1 Unplanned pregnancy
has been associated with uncontrollable growth of population which can be
considered a major health and socioeconomic problem.2  Saudi population increased dramatically in the
recent few years. for example, from 2010 till 2016 the Saudi population
increased 16.54%.3 Unplanned pregnancy has a negative impact on the
family in which it is associated with poor outcomes and psychological  effects on women and child lives.4,5 Women
with unplanned pregnancies are more prone to get depression and increase the
desire to get abortion when compared to women with planned pregnancies.6,7
Many women thought about abortion or even underwent to  abortion and some women after the delivery
developed complication and gave a low birth child.8 In other study
it was  estimated that 43% of women with
unintended pregnancy ended up with abortion.9

In 1999, 38% of pregnancies worldwide has been estimated to be
unintended or unplanned pregnancies.10 Many studies were conducted
worldwide to estimate the prevalence of unplanned pregnancy, for example in UK,
the prevalence of unplanned pregnancy was 16.2%.11 in the middle
east, there was a study conducted In Sudan suggested that the prevalence of
unintended pregnancy was 30.2% and found that it is more in high parity women.12

Our aim in this study was to estimate the prevalence of unplanned
pregnancy among Saudi pregnant women attending the clinics and to determine the
characteristics that may interfere with that prevalence along with
psychological effect.

Material
and methods

Self-administrated survey was conducted randomly among pregnant
women attending obstetric clinics at King Khalid university hospital, Riyadh
city Kingdom of Saudi Arabia during January, February and March 2017. Of whom
358 completed the survey. We excluded IVF (In vitro fertilization) patients or
any type of induced pregnancy, also any patient with pregnancy complications
and any pregnant women known to have psychological disorders and included
completed and partial completed surveys. We used 26 instrumental survey (see
appendix). Our survey contained 3 section. First  section, socio-demographic characteristics of
the respondents. Second section, we used London
measurement of unplanned pregnancy (LMUP) which is  considered validated measure to assess if the
pregnancy was planned or unplanned. By using 6 questions with total score range
from 0 to 12.  If the final results for
this scoring system from 0 to 3 is  considered unplanned pregnancy, from 4 to 9 is
 ambivalent and from 10 to 12 is  planned pregnancy. Third section, we used
Kessler 6-Item Psychological Distress Scales (K6), which is a simple and screening
measure for psychological effect like depression and anxiety and each question
scaled from 1 to 5  and the total score
ranged from 6 to 30.  If the result of
this system range From 6 to 11 it is  considered low , from 12 to 19is  considered mild to moderate and from 20 to 30 is
 considered high. SPSS version 22 was
used for data entry and analysis and P value was defined to be > 0.05.

 Results

A total of 358 surveys were collected. Most of the respondents
(27.9%) age ranged between 26 – 30 years. Concerning residence, most of the
respondents (96.1%) resided in Urban area. (70.9) were unemployed and (66.2)
had a university degree. Regarding 
gravidity and parity, most of respondents were primigravida and
nullparity  (37.2%) and (35%)
respectively.29.9% of the respondents had abortion. Concerning gestational age,
most of the respondents (67.9%) were in the third trimester.

Table 1. summarizes  socio-demographic information of those
respondents.

According to London measurement of unplanned pregnancy (LMUP), we
found that most of the respondents (53.1%) had planned pregnancy, where (34.6%)
and (12.3%) were ambivalent and unplanned respectively, while the median LMUP
score was 10. When LMUP score compared with the socio-demographic information
of the respondents, we found that there were significant findings  with ages, gravidity and parity.  p values were (0.029),(0.004) and (0.015)
respectively.

According to age, we found that the highest percentage of planned
pregnancy (63.08%) were pregnant women age range between 31 – 35 years old.  On the other hand, the highest percentage of
unplanned pregnancy (16.67%) was pregnant women age between 20 -25 years old.
Regarding gravidity, the  highest prevalence
of unplanned pregnancy (31.58%) were among pregnant women with 5 gravidity
while highest prevalence of planned pregnancy (65.75%) were among pregnant
women with 2 gravidity. For parity, we found that highest prevalence of
unplanned pregnancy (30.77%) was  among
pregnant women with 5 parity while the highest prevalence of planned pregnancy
(63.95%) was  among pregnant women with 1
parity.

When the LMUP score compared with other respondents characteristics
like residency, employment, level of education and number of abortions we
didn’t find any significant results. 
Table 2. Summarizes  relationships
between respondents characteristics with 
LMUP score.

In figure 1. Comparison between psychological effect by using
Kessler 6-Item Psychological Distress Scales (K6) and LMUP score, is presented
. It showed that when the pregnancy was planned there was a minimal decrease in
the psychological effect.DiscussionUnplanned pregnancies had a specific effect on women’s lives that
can result in poor outcomes and specific psychological effects. 4,5 There
is no study conducted in Saudi Arabia to measure the prevalence of unplanned
pregnancy. Unique finding in our study despite cultural and religious issues
among Saudi population regarding determination  of the pregnancy either planned or not .we
found that, the prevalence of unplanned pregnancy was 12.3% which is
different  when compared to other
populations study.  For example in UK, it
was 16.2% and in USA, by the year of 2006 it was 49%.9,11.We  believe
that cultural and religious and other issues may play an important role in that
discrepancy . We found that pregnant women with increasing in age had more
planned pregnancy compared to younger women.  On the other hand, we observed that women with
increasing in gravidity and parity are more prone to have unplanned pregnancy
when compared to other groups. Study done in Sudan found that prevalence of
unintended pregnancy is increasing in women with high parity.12 There
is no significant effect of the  Level of
education, employment and residency in the  determination if the pregnancy to be planned
or unplanned. We revealed that, the pregnant women who had current planned
pregnancy had a minimal psychological effect when compared to those with
unplanned pregnancy. This conclusion is supported with other findings in which
the unplanned pregnancy is associated with minimal psychological effects.4,5  Limitations have to be considered in the present study. It was done
on a very small size of women. This small number of participants affect the
overall outcomes of the study and consequently we cannot generalize the results
to represent the Saudi society. We belief that the selection of the
participants was biased since we included the patients attending the clinics
during a specific period of time. Also, and we excluded In vitro fertilization patients
or any type of induced pregnancy. Moreover,  any patient with pregnancy complications as
well as exclusion of   any pregnant women
known to have psychological disorders . Also, the use of screening scale is not
considered an optimal way to determine such a psychological consequences of
such problem. Conclusion
Unplanned pregnancy has been
associated with psychological distress and poor outcomes to the mother and baby
as well as associated with an  increase
in  the growth in population number.  It is a public health and economic problem in
the society. We should increase the public awareness regarding the effects of
unplanned pregnancy and associated outcomes and to identify the role of
contraceptions in avoiding phenomena. We need more studies on larger population
samples  to estimate the actual
percentage of unplanned pregnancy.Acknowledgement:
there is no funding for this manuscript. 

Conflict
of interest: there is no conflict of interest.

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