Pregnancy intention and birth outcomes: does the relationship differ by age or race?

We hypothesized that intended pregnancy is associated with decreased risk of poor birth outcomes, irrespective of age or race.

We conducted a cross-sectional study of 47,956 live singleton births using 1993-2001 data from the Centers for Disease Control and Prevention's (CDC) Pregnancy Risk Assessment Monitoring System (PRAMS). We used logistic regression to estimate the odds of giving birth to a very low birth weight/very preterm infant (VLBW/VPT) or an infant admitted to the neonatal intensive care unit (NICU) by pregnancy intention.

Intended pregnancy was associated with a slightly higher risk than unintended pregnancy of a VLBW/VPT birth in young white women (< or = 22 years) and black women of all ages. Intended pregnancy was associated with a slightly higher risk of infant NICU admission in white women under age 28 but with a lower or equivalent risk of infant NICU admission for black women of all ages than unintended pregnancy. From ages 22 to 37, black women had a significantly higher risk of VLBW/VPT birth with intended pregnancies than white women, but from ages 18 to 32, white women were at significantly more risk than black women of requiring infant NICU admission with intended pregnancies.

Contrary to our hypothesis, an intended pregnancy at a young age was associated with a higher risk of poor birth outcomes.