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Unintended pregnancy: Risk factors and perinatal outcomes in a nulliparous population
Rebecca J Post1, Luke Schmidt1, Brian A Crosland2
1Department of Obstetrics and Gynecology University of California Irvine Medical Center Orange California USA.
Pregnancy (Hoboken, N.J.)
|August 14, 2026
Summary
Unplanned pregnancies in nulliparous individuals receiving early prenatal care did not lead to adverse perinatal outcomes. However, these individuals showed increased mental illness treatment during and after pregnancy.
Area of Science:
- Reproductive Health
- Maternal-Fetal Medicine
- Psychiatry
Background:
- Unintended pregnancies are linked to delayed prenatal care and poor pregnancy outcomes.
- Focusing on nulliparous individuals with early prenatal care eliminates confounding factors from prior births or late care initiation.
Purpose of the Study:
- To examine maternal risk factors and perinatal outcomes in unintended pregnancies among nulliparous individuals with early prenatal care.
Main Methods:
- Secondary analysis of the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b) cohort.
- Included 10,038 nulliparous individuals followed from the first trimester.
- Compared maternal characteristics and outcomes of planned versus unplanned pregnancies using multivariable logistic regression.
Main Results:
- 41.5% of 10,020 participants reported unplanned pregnancies.
- Unplanned pregnancies were associated with younger age, non-Hispanic Black or Asian race, single marital status, lower socioeconomic status, and pre-pregnancy alcohol/tobacco use.
- No increased likelihood of mental illness history in unplanned pregnancies.
- Treatment for mental illness during pregnancy/postpartum remained significantly associated with unplanned pregnancy (aOR 1.29, p=0.04).
Conclusions:
- Nulliparous individuals with unplanned pregnancies receiving early prenatal care did not experience more adverse perinatal outcomes than those with planned pregnancies.
- These individuals had higher rates of mental illness treatment during and postpartum.
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