RESEARCH – May 2013

Factors associated with unplanned pregnancies among different ethnic groups in Estonia

Authors: Hedda Lippus, Made Laanpere, Tarmo Tuisk, Helle Karro

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Aim. The study was designed to assess selected socio-demographic factors and risky health behaviour associated with unplanned pregnancy among 15–44-year-old pregnant women in Estonian-speaking and Russian-speaking study groups in Estonia, who had decided to give birth.

Methods. The data were obtained from the international unselected cohort study BIDENS. In Estonia five antenatal clinics were included. Women were invited at an antenatal visit at a gestational age of 17 to 28 weeks. The total number of participants was 977 of whom 768 (78.6%) filled in the questionnaire in the Estonian language and 209 (21.4%) filled it in the Russian language. The associations bet ween unplanned pregnancy and socio-demographic factors, reproductive health, risky health behaviour (smoking) and violence experience in adulthood were investigated using logistic regression, and to find statistically significant differences between the two groups, the 2 test was used.

Results. e prevalence of unplanned pregnancy was lower among the Estonianspeaking women compared with the Russianspeaking women (20.4% and 30.8%, respectively, p < 0.002). e Estonian-speaking women who reported unplanned pregnancy differed significantly (p < 0.05) in age, education, occupation, marital status, parity and previous abortions, from the women who had planned pregnancy. Among the Russian-speaking women we found statistically signifi cant diff erences in education and marital status only. Statistically signifi cant diff erences between the women with planned 260 Eesti Arst 2013; 92(5):253–260 and unplanned pregnancies were found in risky health behaviour and in exposure to violence in adulthood for both study groups. Using logistic regression analysis, we found associations of unplanned pregnancy with age, education and marital status for both study groups. Higher prevalence of risky behaviour (smoking during pregnancy) was associated with unplanned pregnancy among the Russian-speaking respondents (adjusted odds ratio 4.43; 95% CI 1,41–13,86). Exposure to violence in adulthood was associated with unplanned pregnancy before adjustment for the other factors.

Conclusion. Unplanned pregnancies account for a substantial proportion of all pregnancies in Estonia. The importance of different factors associated with unplanned pregnancy varies between the two ethnic groups. In order to plan and design culturally targeted interventions to prevent unplanned pregnancies, it is crucial to understand socio-demographic and behavioural determinants in different ethnic groups. More attention should be paid to family planning services, postpartum and abortion contraceptive counselling, screening of violence and smoking cessation counselling, especially among the Russian speaking population.