INTRODUCTION: Nearly half of the pregnancies in the United States are unintended. Several studies have found predictors of unintended pregnancies including contraception use; however, none has addressed modifiable risk factors in a specific population. This study assessed the risk factors for subsequent pregnancy rates within 18 months of a delivery from our obstetrics–gynecology residency clinic at a large community hospital.
METHODS: Retrospective data were collected for hospital deliveries from the resident staffed clinic from June 2011 to January 2013. Coding information and hospital documentation were used to obtain patient demographics and to identify patients who returned within 18 months with a subsequent pregnancy. Separate univariate analyses were conducted to determine if there were significant differences in certain demographic and clinical variables between patients with and without subsequent pregnancies.
RESULTS: Of 901 deliveries, 89 (9.9%) had an early subsequent pregnancy. Age, race, parity, work status, insurance status, breastfeeding, postpartum follow-up, and immediate postpartum Depo-Provera injection were compared. Only age (26.7 compared with 28.4 years, P=.01) and postpartum visit (59.1% compared with 67.4%, P=.05) were significantly different.
CONCLUSION: A potential modifiable risk factor is postpartum visits (P=.05). During this postpartum visit, a focused contraception discussion may decrease subsequent unintended pregnancies; thus, programs to increase postpartum visits may be worthwhile. A future study is underway to potentially increase the postpartum visit rate.
Financial Disclosure: Priyanka Zutshi, MD, Ingrid Paredes, MD, Heather Winn, BS, Jill Stoltzfus, PhD, and James Anasti, MD—These authors have no conflicts of interest to disclose relative to the contents of this presentation.
© 2014 by The American College of Obstetricians and Gynecologists.