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Factors associated with unintended pregnancy in Brazil: cross-sectional results from the Birth in Brazil National Survey, 2011/2012
Background
Unintended pregnancy, a pregnancy that have been either unwanted or mistimed, is a serious public health issue in Brazil. It is reported for more than half of women who gave birth in the country, but the characteristics of women who conceive unintentionally are rarely documented. The aim of this study is to analyse the prevalence and the association between unintended pregnancy and a set of sociodemographic characteristics, individual-level variables and history of obstetric outcomes.
Methods
Birth in Brazil is a cross-sectional study with countrywide representation that interviewed 23,894 women after birth. The information about intendedness of pregnancy was obtained after birth at the hospital and classified into three categories: intended, mistimed or unwanted. Multinomial regression analysis was used to estimate the associations between intendedness of a pregnancy, and sociodemographic and obstetric variables, calculating odds ratios and 95 % confidence intervals. All significant variables in the bivariate analysis were included in the multinomial multivariate model and the final model retaining variables that remained significant at the 5 % level.
Results
Unintended pregnancy was reported by 55.4 % of postpartum women. The following variables maintained positive and significant statistical associations with mistimed pregnancy: maternal age < 20 years (OR = 1.89, 95 % CI: 1.68–2.14); brown (OR = 1.15, 95 % CI: 1.04–1.27) or yellow skin color (OR = 1.56, 95 % CI: 1.05–2.32); having no partner (OR = 2.32, 95 % CI: 1.99–2.71); having no paid job (OR = 1.15, 95 % CI: 1.04–1.27); alcohol abuse with risk of alcoholism (OR = 1.25, 95 % CI: 1.04–1.50) and having had three or more births (OR = 2.01, 95 % CI: 1.63–2.47). The same factors were associated with unwanted pregnancy, though the strength of the associations was generally stronger. Women with three or more births were 14 times more likely to have an unwanted pregnancy, and complication in the previous pregnancies and preterm birth were 40 % and 19 % higher, respectively. Previous neonatal death was a protective factor for both mistimed (OR = 0.61, 95 % CI: 0.44–0.85) and unwanted pregnancy (OR = 0.44, 95 % CI: 0.34–0.57).
Conclusions
This study confirms findings from previous research about the influence of socioeconomic and individual risk factors on unintended pregnancy. It takes a new approach to the problem by showing the importance of previous neonatal death, preterm birth and complication during pregnancy as risk factors for unintended pregnancy
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Dependência de exercÃcio fÃsico: humor, qualidade de vida em atletas amadores e profissionais Physical exercise dependence: mood, quality of life in amateur and professional athletes
O objetivo do presente estudo foi verificar se existem diferenças nos escores de Dependência de ExercÃcio (DE), escores de humor e qualidade de vida em atletas profissionais e amadores de modalidade esportivas coletivas e individuais. MÉTODOS: Participaram deste estudo 116 atletas praticantes de modalidades esportivas coletivas (n = 60, sendo 20 profissionais e 40 amadores) e individuais (n = 56, sendo 16 profissionais e 40 amadores) do gênero masculino. As médias (± desvio-padrão) da idade, estatura, massa corporal e Ãndice de massa corpórea (IMC) foram: 22,13 ± 6,16 anos; 1,77 ± 0,10cm; 72,76 ± 10,04kg; e 23,10 ± 2,04kg/m², respectivamente. Os atletas responderam aos seguintes questionários: Escala de Dependência de ExercÃcio (EDE), Inventário Beck de Depressão, Idate Traço e Estado de Ansiedade, Questionário POMS de perfil de humor, Questionário SF-36 de Qualidade de Vida, em um dia de folga dentro da periodização normal de treinamento, caracterizando o estudo como transversal. O trabalho foi aprovado pelo Comitê de Ética em Pesquisa da Unifesp (# 0616/06). RESULTADOS: Atletas amadores e profissionais apresentaram escores similares de DE, mas quando considerados os tipos de modalidade, os amadores praticantes de modalidades coletivas apresentam maiores escores, o que se inverte quando considerados atletas profissionais. Em relação aos resultados de humor, atletas profissionais apresentaram mais qualidade de vida e menores escores de humor. CONCLUSÃO: Atletas amadores e profissionais praticantes de modalidades esportivas coletivas e individuais respondem diferentemente à DE; o tipo de modalidade e seu envolvimento social e competitivo parecem ser o grande determinante. Além disso, pode-se concluir que atletas profissionais de modalidades coletivas apresentam melhor perfil de humor e qualidade de vida, tanto quando comparados com profissionais de modalidades individuais, quando com atletas amadores praticantes de modalidades coletivas ou individuais.<br>The purpose of this study was to verify if there are differences between exercise dependence (ED), mood and quality of life scores in professional and amateur athletes of individual and collective sport modalities. METHODS: 116 male athletes of collective sport modalities (n=60, 20 professionals and 40 amateurs) and individual sport modalities (n=56, 16 professionals and 40 amateurs) participated in this study. Age, height, weight, BMI mean (± standard-deviation) were: 22.13 ± 6.16 years; 1.77 ± 0.10 cm; 72.76 ± 10.04 kg and 23.10 ± 2.04 kg/m², respectively. The athletes answered the following questionnaires: Exercise Dependence scale (EDE), Beck Depression Inventory, Trait and State of Anxiety - IDATE, POMS - profile of mood states, SF-36 Questionnaire of Quality of Life. The study was approved by the Ethics in Research Committee of UNIFESP (#0616/06). RESULTS: Amateur and professional athletes presented similar scores of ED, but when the kind of modality was considered, the amateurs of collective modalities presented higher scores than professional athletes. CONCLUSION: Amateur and professional athletes of collective and individual sport modalities answered differently to ED, and the sports modality and competitive and social involvement could be determinant. Moreover, it is possible to conclude that professional athletes of collective sports present better profile of mood and quality of life when compared with professional athletes of individual sports when compared with amateur athletes from collective or individual sport modalities