Large number of unplanned pregnancies among women with chronic health conditions

A large number of women with chronic health conditions have unplanned pregnancies and are at risk of experiencing adverse events during pregnancy, something a University of Otago researcher says could be prevented if healthcare professionals are prepared.

Sociologist Dr. Bryndl Hohmann-Marriott has discovered unplanned pregnancies are reported by about half of all pregnant women with chronic health conditions in New Zealand. This was a higher proportion than among women without health conditions. Her research is published in today’s New Zealand Medical Journal.

Using data from the Growing up in New Zealand study of 6822 pregnant women, she says 45 percent of pregnant women with a chronic health condition reported their pregnancies as unplanned, compared to 39 percent of pregnant women without health conditions.

In 2008, there would have been an estimated 2200 unplanned pregnancies of women with asthma, over 1300 of women with depression, nearly 700 with anxiety, nearly 500 with heart disease and nearly 400 with diabetes.

“This is a substantial number of women with unplanned pregnancies and chronic conditions who are at an elevated risk of not receiving preconception and antentatal care, and thus a higher chance of experiencing adverse events in their pregnancies,” Dr. Hohmann-Marriott explains.

“This risk can be mitigated by health practitioners, particularly midwives and obstetricians, who are prepared to provide care to women with chronic health conditions whose pregnancies are a surprise.”

There has been an overall increase in the number of pregnant women with chronic health conditions in New Zealand, partly due to the rising age of women at childbearing, Dr. Hohmann-Marriott says.

These conditions increase the risk of adverse events and outcomes during and after pregnancy, including stillbirth, preterm birth, Caesarean delivery, low birth weight or macrosomia, hypertensive and cardiac complications and postnatal depression.

Among pregnant women with chronic health conditions who were on a low income, young, did not have a coresident partner and had less education, between half to nearly 80 percent of pregnancies were reported as unplanned.

“Both chronic illness and unplanned pregnancy are more prevalent and pose greater risks in the presence of socio-economic disadvantage. Together, they create a high-risk situation that is rarely considered,” Dr. Hohmann-Marriott says.

Women with a chronic health condition are usually already connected with the healthcare system, offering an enhanced opportunity for professionals to support them across their reproductive lifecourse, she says.

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