title: A longitudinal study of unplanned pregnancy in a maternity hospital setting.
abstract: OBJECTIVE
  To review family planning in a cohort of women who delivered a second child within 3 years of their first.
  
  
  METHODS
  A longitudinal, observational study included women aged at least 18 years who had delivered a singleton weighing at least 500 g in 2009 after their first pregnancy at a hospital in Dublin, Ireland, and who returned to the hospital for prenatal care for a second pregnancy before January 2012. Logistic regression analyses were performed to examine the effect of maternal characteristics on pregnancy intention.
  
  
  RESULTS
  Of 3284 primigravidas who delivered in 2009, 1220 (37.1%) returned with a second pregnancy. The second pregnancy was unplanned in 248 (20.3%) women, and both pregnancies were unplanned in 124 (10.2%). The second pregnancy was more likely to be unplanned in women whose first pregnancy was also unplanned than in those whose first was planned (adjusted odds ratio 6.5; 95% confidence interval 4.6-8.4; P<0.001). Among the 99 women with recurrent unplanned pregnancy who had not been using contraception before the first pregnancy, 85 (85.9%) were also not using contraception before the second.
  
  
  CONCLUSIONS
  Women whose first pregnancy is unplanned are at increased risk of subsequent unplanned pregnancies. Postnatal contraceptive advice in this high-risk group should be prioritized.
authors.affiliation: UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland. Electronic address: aoifemckeating@gmail.com.
authors.forename: Aoife
authors.initials: A
authors.lastname: McKeating
authors.affiliation: UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland.
authors.forename: David A
authors.initials: DA
authors.lastname: Crosby
authors.affiliation: UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland.
authors.forename: Martha
authors.initials: M
authors.lastname: Collins
authors.affiliation: UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland.
authors.forename: Amy
authors.initials: A
authors.lastname: O'Higgins
authors.affiliation: UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland.
authors.forename: Léan
authors.initials: L
authors.lastname: McMahon
authors.affiliation: UCD Centre for Human Reproduction, Coombe Women and Infants University Hospital, Dublin, Ireland.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Turner
mesh_terms: D000328:Adult; D003267:Contraception / Q000706:statistics & numerical data*; D005193:Family Planning Services / Q000379:methods*; D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D007494:Ireland; D008137:Longitudinal Studies; D011247:Pregnancy; D049168:Pregnancy, Unplanned; D012044:Regression Analysis; D012306:Risk; D055815:Young Adult
keywords: Contraception; Family planning; Unplanned pregnancy