Gravidez não planejada, violência doméstica e métodos contraceptivos em mulheres em idade fértil do Ceará

Abstract

Unplanned pregnancy is an important public health issue, strongly associated with adverse health outcomes, socioeconomic impacts, and high rates of domestic violence. Despite extensive global studies, in Ceará, research on factors associated with unplanned pregnancies remains insufficient. This study aimed to identify the characteristics and main factors associated with reproductive planning through the prevalence of unplanned pregnancies among women of childbearing age in the state of Ceará. To this end, a population-based cross-sectional study was conducted using data from the seventh edition of the Ceará Maternal and Child Health Survey (PESMIC). The dependent variable was unplanned pregnancy, defined as any pregnancy that the woman had not planned and/or did not want at that particular time in her life. The prevalence of unplanned pregnancy was 31.8%. Women with education up to elementary school were 20% more likely to have had an unplanned pregnancy (Adjusted Odds Ratio [aOR]=1.2; 95%CI: 1.1–1.4; p=0.005) than those with education at the high school level or higher. Women who used intrauterine devices (IUD) (aOR=1.5; 95%CI: 1.0–2.3; p=0.035) and those who had previously used emergency contraception (aOR=1.4; 95%CI: 1.2–1.7; p<0.001) were 50% and 40% more likely, respectively, to report an unplanned pregnancy. Women living in households where there were frequent conflicts (aOR=1.9; 95%CI: 1.4– 2.8; p<0.001) or who had experienced physical aggression (aOR=1.9; 95%CI: 1.4–2.6; p<0.001) were nearly twice as likely to have experienced an unplanned pregnancy. These findings highlight the complex interplay between social, behavioral, and domestic violence factors influencing unplanned pregnancy rates in Ceará. The data produced by this study can contribute to the creation and improvement of public policies aimed at women's health.