Planificación del embarazo: prevalencia y aspectos asociados

The aims were to know the prevalence of and associated aspects to the planned pregnancy. Using the Brazilian version of the London Measure of Unplanned Pregnancy, we classified the pregnancy of 126 women who had a positive urine pregnancy test in primary health centers in the city of Marília, São Paulo. The prevalence of planned pregnancy was 33.3% [25.2%-42.3%]. We found that age, partners age, living with a partner, having a previous pregnancy and a previous abortion or miscarriage were positively associated to the planning of the pregnancy. We conclude that planning a pregnancy is not frequent yet and is mainly determined by personal and relational contexts of a woman's life as well as by their reproductive history and not simply by contraception use or schooling, as it has been traditionally considered.Se objetivó estimar la prevalencia de embarazo planificado y analizar los aspectos asociados a él. El embarazo planificado fue evaluado por London Measure of Unplanned Pregnancy, versión brasileña. Fueron estudiadas 126 mujeres que se presentaron en unidades básicas de salud de Marília, São Paulo, para confirmación de gravidez, con resultado positivo. La prevalencia de embarazo planificado fue 33,3% [25,2%-42,3%]. Los aspectos asociados positivamente al embarazo planificado fueron: edad, edad del compañero, cohabitación con el compañero, haber estado embarazada anteriormente y haber experimentado un aborto anterior. El planeamiento del embarazo aún no es un evento frecuente y está determinado, sobre todo, por el contexto personal y afectivo de las mujeres, así como por su trayectoria reproductiva; y no simplemente por el uso de métodos anticonceptivos o nivel de escolaridad, como tradicionalmente se ha pensado.Os objetivos foram estimar a prevalência de gravidez planejada e analisar os aspectos a ela associados. Gravidez planejada foi avaliada pelo London Measure of Unplanned Pregnancy, versão Brasil. Foram estudadas 126 mulheres que procuraram unidades básicas de saúde de Marília, São Paulo para confirmação da gravidez e que tiveram resultado positivo. A prevalência de gravidez planejada foi 33,3% [25,2%-42,3%]. Os aspectos positivamente associados ao planejamento da gravidez foram idade, idade do parceiro, coabitação com parceiro, ter engravidado anteriormente e ter vivenciado um abortamento anterior. O planejamento da gravidez ainda não é evento freqüente e está determinado, sobretudo, pelos contextos de vida pessoal e afetiva das mulheres, bem como por sua trajetória reprodutiva, e não simplesmente pelo uso de métodos contraceptivos ou nível de escolaridade, como tradicionalmente se tem pensado

Evaluation of the psychometric properties of the London Measure of Unplanned Pregnancy in Brazilian Portuguese

Background: Estimates of unplanned pregnancy worldwide are of concern, especially in low and middle-income countries, including Brazil. Although the contraceptive prevalence rate is high in Brazil, almost half of all pregnancies are reported as unintended. The only source of nationally representative data about pregnancy intention is the Demographic and Health Survey, as with many other countries. In more recent years, however, it has been realized that concept of unintended pregnancy is potentially more complex and requires more sophisticated measurement strategies, such as the London Measure of Unplanned Pregnancy (LMUP). The LMUP has been translated and validated in other languages, but not Portuguese yet. In this study, we evaluate the psychometric properties of the LMUP in the Portuguese language, Brazilian version. Methods: A Brazilian Portuguese version of the LMUP was produced via translation and back-translation. After piloting, the mode of administration was changed from self-completion to interviewer-administration. The measure was field tested with pregnant, postpartum, and postabortion women recruited at maternity and primary health care services in Sao Paulo city. Reliability (internal consistency) was assessed using Cronbach’s alpha and item-total correlations. Construct validity was assessed using principal components analysis and hypothesis testing. Scaling was assessed with Mokken analysis. Results: 759 women aged 15–44 completed the Brazilian Portuguese LMUP. There were no missing data. The measure was acceptable and well targeted. Reliability testing demonstrated good internal consistency (alpha = 0.81, all item-rest correlations >0.2). Validity testing confirmed that the measure was unidimensional and that all hypotheses were met: there were lower LMUP median scores among women in the extreme age groups (p<0.001), among non-married women (p<0.001) and those with lower educational attainment (p<0.001). The Loevinger H coefficient was 0.60, indicating a strong scale. Conclusion: The Brazilian Portuguese LMUP is a valid and reliable measure of pregnancy planning/intention that is now available for use in Brazil. It represents a useful addition to the public health research and surveillance toolkit in Brazil

Cultural adaptation and validation for the portuguese language of an instrument for measuring unplanned pregnancies (London Measure of Unplanned Pregnancy)

Diante da importância que a gravidez não planejada vem adquirindo no cenário mundial, apesar da melhoria nas tecnologias contraceptivas e ampliação do acesso aos serviços de saúde e métodos contraceptivos, faz-se necessário mensurar com maior precisão este fenômeno. Por esta razão, pesquisadores da área de saúde sexual e reprodutiva têm procurado desenvolver medidas que possam oferecer estimativas confiáveis de mulheres que vivenciam a gravidez não planejada. A maior parte dos instrumentos utilizados para mensurar a gravidez não planejada são unidimensionais e não levam em consideração a parceria, a intencionalidade ou o uso de métodos anticonceptivos de forma simultânea, aspecto não observado no London Measure of Unplanned Pregnancy (LMUP), desenvolvido no Reino Unido. Nesse contexto, este estudo transversal tem como objetivo traduzir e adaptar o instrumento LMUP para a língua portuguesa e validar suas propriedades, visando à sua utilização como instrumento de mensuração de gravidez não planejada no Brasil. A adaptação cultural e validação do LMUP foram realizadas conforme o método preconizado pela literatura. O cenário de estudo foram unidades da rede de Atenção Básica do município de Marília-SP. A população de estudo foi composta por 126 mulheres com idade 18 e 42 anos, usuárias dessas unidades, que procuraram a Unidade para confirmação do diagnóstico da gravidez por meio de um teste imunológico para gravidez cujo resultado foi positivo. Os resultados obtidos demonstraram que em relação às propriedades psicométricas, o instrumento apresenta um valor de apha de Cronbach de 0,75 para a escala total. A análise fatorial exploratória dos componentes principais do instrumento LMUP na versão Português aqui apresentada resultou em um único fator, que explicou 66,5% da variância total dos dados. As propriedades psicométricas do instrumento foram demonstradas e, portanto ele pode ser utilizado para mensurar a gravidez não planejada na população brasileira.Facing the impact that unplanned pregnancy is acquiring world wide, despite the improvement in contraceptive technologies and increasing access to health services and contraceptive methods, it is necessary to measure this phenomenon more accurately. For this reason, researchers in the sexual and reproductive health field have sought to develop measures that can provide reliable estimates of women experiencing unplanned pregnancies. Most instruments used to measure the unplanned pregnancy are unidimensional and do not take into account the partnership, the intent or the use of contraceptive methods simultaneously, a not observed aspect at London Measure of Unplanned Pregnancy (LMUP), developed in the United Kingdom. Thus, this cross-sectional study is aimed to translate and adapt the instrument LMUP to Portuguese and validate its properties, aiming at its use as an instrument for measuring unintended pregnancy in Brazil. Cultural adaptation and validation of LMUP were done according to the method recommended by the literature. The scenery for the study was units of the network of Primary Care in Marília-SP. The studied population consisted of 126 women aged between 18 and 42 years, users of these units, who sought for this Unit to confirm the diagnosis of pregnancy by means of an immunological test for pregnancy and the result was positive. The results showed that in relation to psychometric properties, the instrument has a Cronbach\'s alpha value of 0.75 for the total scale. The factor analysis of the main components of the LMUP to the Portuguese version presented here has resulted in one factor, which explained 66.5% of the total variance of the data. The instrument\'s psychometric properties were demonstrated, and, therefore, it can be used to measure the unplanned pregnancy of the Brazilian population