Unintended pregnancy raises risk of future ones

NEW YORK (Reuters Health) - Women and girls who've had an unplanned pregnancy in the past are at risk of future unplanned pregnancies, regardless of other risk factors like age and education, a new study shows.

Researchers found that of 542 women and teenage girls enrolled in a study to encourage contraceptive use, those with a history of unplanned pregnancy were twice as likely as other women to have another unplanned pregnancy over the next two years.

Age and education emerged as the strongest risk factors for an unplanned pregnancy; teenagers were three times more likely than women older than 24 to have an unintended pregnancy, and women with less than a high school education had a similarly elevated risk.

But even with those and other factors considered, a history of unplanned pregnancy remained linked to a heightened risk of future ones, the researchers report in the American Journal of Obstetrics & Gynecology.

About half of pregnancies in the U.S. are unplanned, a figure that represents a "serious public health concern," write the researchers, led by Lindsay M. Kuroki of Brown University in Providence, Rhode Island.

For example, they note, compared with other pregnant women, those with unintended pregnancies are less likely to get early prenatal care and more likely to smoke, drink or use drugs. As a result, their babies are at greater risk of problems like low birthweight and prematurity.

Figuring out which women are at particularly high risk of unplanned pregnancies is key to preventing them, Kuroki's team writes. Based on the current findings, they say, asking a woman about her history of unplanned pregnancy is a good way to estimate her risk of one in the future -- and whether she needs more help with family planning.

"Ensuring access to family planning services, promoting usage of the most reliable forms of contraception, and providing appropriate support and resources is essential in the effort to prevent unplanned pregnancy," the researchers write.

SOURCE: American Journal of Obstetrics & Gynecology, November 2008.