Epidemiological, Educational, and Socioeconomic Factors Associated with Pregnancy Planning in a Public Maternity Hospital: A Cross-Sectional Study in Curitiba
Description
This study was based on the hypothesis that pregnancy planning status is associated with sociodemographic, educational, and reproductive factors among women receiving care in the Brazilian Unified Health System (SUS). We hypothesized that unplanned pregnancies would be more frequent among younger women, those with lower educational and socioeconomic levels, limited access to formal sexual education, reduced contraceptive use, and lower social support, while planned pregnancies would be associated with greater social stability and reproductive autonomy. To investigate this hypothesis, a cross-sectional survey was conducted with 260 pregnant women attending a public maternity hospital in Curitiba, Brazil, between May 2024 and August 2025. Data were collected using a structured online questionnaire administered via Google Forms. The instrument included the Brazilian validated version of the London Measure of Unplanned Pregnancy (LMUP) and additional questions addressing sociodemographic characteristics, reproductive and contraceptive history, sexual education, and partner support. Based on LMUP scores, pregnancies were classified as unplanned, ambivalent, or planned. The data show that most pregnancies were classified as ambivalent (57.7%), followed by planned (28.8%) and unplanned (13.5%). Unplanned pregnancy was significantly associated with younger maternal age, absence of a stable partner, lower educational attainment, higher household density, and lack of prior contraceptive use. Women in this group also reported lower exposure to formal sexual education—particularly in school—and greater reliance on informal sources such as friends. Additionally, unplanned pregnancies were marked by substantially lower support from the baby’s father. Ambivalent pregnancies presented an intermediate profile, characterized by women in early adulthood, moderate socioeconomic conditions, higher prior contraceptive use, and greater exposure to sexual education through schools and healthcare professionals. Planned pregnancies were more frequent among older women, those in stable marital relationships, formally employed, living in less crowded households, with greater familiarity and prior use of contraceptive methods, and near-universal partner support. Overall, the findings support the study hypothesis and indicate that pregnancy planning exists along a continuum rather than as a binary outcome. The data highlight the role of social vulnerability, access to education, and reproductive health services in shaping pregnancy intention. These results can be used to guide public health policies aimed at improving sexual education, expanding contraceptive counseling, and strengthening family planning strategies within the SUS, particularly for socially vulnerable populations.
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This study included pregnant women receiving care at a public maternity hospital within the Brazilian Unified Health System (SUS) between May 2024 and August 2025. Participants were recruited among women who were hospitalized or awaiting outpatient consultation during the data collection period. Eligible participants were pregnant women who: (i) received care at the SUS maternity hospital during the study period; (ii) fully completed the Brazilian version of the London Measure of Unplanned Pregnancy (LMUP); and (iii) provided complete data for sociodemographic, reproductive, and sexual education variables. Exclusion criteria included incomplete questionnaires, inconsistent responses, or missing essential information required for LMUP classification. Pregnancy planning status, the primary outcome, was assessed using the Brazilian validated version of the London Measure of Unplanned Pregnancy (LMUP). This instrument consists of six items evaluating contraceptive use, timing of pregnancy, prior intention, desire to conceive, partner agreement, and preconception behaviors. Each item is scored from 0 to 2, generating a total score from 0 to 12. According to standard recommendations, pregnancies were classified as unplanned (0–3), ambivalent (4–9), or planned (10–12). Additional variables included sociodemographic characteristics (age, education, income, marital status), household composition, reproductive and contraceptive history, sexual education (sources of information such as school, healthcare professionals, and peers), and social support (father’s involvement). Data were collected through a structured online questionnaire administered via Google Forms, which included the LMUP items and questions related to reproductive history, sexual education, and the use of mood-stabilizing medications, including diagnosis and treatment adherence when applicable. All data were self-reported. Responses were exported and organized into a database using Microsoft Excel®. To minimize bias, only fully completed questionnaires were analyzed. Standardized definitions were applied across all variables, and pregnancy planning classification relied exclusively on objective LMUP scoring criteria. Data entry and consistency were verified through double-checking procedures. Statistical analysis comprised descriptive and inferential methods. Categorical variables were summarized using absolute and relative frequencies. Comparisons among pregnancy planning groups were performed using Pearson’s chi-square test or Fisher’s exact test, as appropriate. Statistical significance was set at p < 0.05.