Prevalence and correlates of very rapid repeat pregnancy: Pregnancy Risk Assessment Monitoring System, United States, 2009–2020

Author:

Luff Amanda12ORCID,Menegay Michelle3,Gallo Maria F.1

Affiliation:

1. Division of Epidemiology, College of Public Health Ohio State University Columbus Ohio USA

2. Advocate Aurora Research Institute Aurora Health Care, Advocate Health Miwaukee WI USA

3. Ohio Colleges of Medicine Government Resource Center Ohio State University Wexner Medical Center Columbus Ohio USA

Abstract

AbstractBackgroundMost rapid repeat pregnancies, defined as those occurring within 18 months of a previous birth, are unintended. These pregnancies are associated with later initiation of prenatal care and are more common among people with lower socio‐economic status and among racially and ethnically minoritised populations.ObjectivesTo assess prevalence and correlate pregnancies occurring in the immediate period after a live birth in the United States, using the Pregnancy Risk Assessment Monitoring System (PRAMS).MethodsWe assessed data from the 2009–2020 PRAMS, a population‐based survey of perinatal maternal characteristics of mothers of liveborn infants in US locations. We assessed pregnancies reported during the immediate postpartum period (approximately 2–6 months post‐delivery), and term this ‘very rapid repeat pregnancy’ (VRRP). We assessed the adjusted prevalence of VRRP from 2009 to 2020. From 2016 to 2020, we calculated adjusted prevalence ratios (aPR) with 95% confidence intervals (CI) for maternal characteristics.ResultsThe adjusted prevalence of VRRP ranged from 0.38% (95% CI: 0.29, 0.48) in 2009 to 0.76% (95% CI: 0.61, 0.91) in 2020. Demographic characteristics associated with VRRP included younger age, lower educational attainment, and being unmarried. Black mothers had a higher prevalence of VRRP compared to white mothers. Mothers who attended a healthcare visit in the 12 months preconception had a lower prevalence of VRRP as did mothers who attended a postpartum check‐up, compared to their counterparts without these visits. Among those receiving prenatal care, mothers whose prenatal healthcare provider asked about postpartum contraception birth had a lower prevalence of VRRP, compared to those not asked about postpartum contraception.ConclusionsVRRP appeared to increase over time in 2009–2020. Mothers who are younger, Black, have lower educational attainment, or who did not attend healthcare visits before or after pregnancy had a higher prevalence of VRRP and may comprise a population who would benefit from additional family planning resources.

Funder

Eunice Kennedy Shriver National Institute of Child Health and Human Development

Publisher

Wiley

Subject

Pediatrics, Perinatology and Child Health,Epidemiology

Reference30 articles.

1. Inter-pregnancy interval and adverse outcomes: Evidence for an additional risk in health disparate populations

2. Short Interpregnancy Intervals in the United States

3. Short interpregnancy intervals in 2014: differences by maternal demographic characteristics;Thoma ME;NCHS Data Brief,2016

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1. Differences in Self-Reported and Billed Postpartum Visits Among Medicaid-Insured Individuals;JAMA Network Open;2023-12-27

2. Using mothers as the denominator;Paediatric and Perinatal Epidemiology;2023-12-04

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