Background: There has been considerable debate in the reproductive health literature as to whether unintended\r\npregnancy influences use of maternal health services, particularly antenatal care. Despite the wealth of studies\r\nexamining the association between pregnancy intention and antenatal care, findings remain mixed and\r\ninconclusive. The objective of this study is to systematically review and meta-analyse studies on the association\r\nbetween pregnancy intention and antenatal care.\r\nMethods: We reviewed studies reporting on pregnancy intention and antenatal care from PubMed, Popline, CINHAL\r\nand Jstor search engines by developing search strategies. Study quality was assessed for biases in selection, definition of\r\nexposure and outcome variables, confounder adjustment, and type of analyses. Adjusted odds ratios, standard errors\r\nand sample size were extracted from the included studies and meta-analyzed using STATA version 11. Heterogeneity\r\namong studies was assessed using Q test statistic. Effect-size was measured by Odds ratio. Pooled odds ratio for the\r\neffects of unintended pregnancy on the use of antenatal care services were calculated using the random effects model.\r\nResults: Our results indicate increased odds of delayed antenatal care use among women with unintended\r\npregnancies (OR 1.42 with 95% CI, 1.27, 1.59) as compared to women with intended pregnancies. Sub-group analysis\r\nfor developed (1.50 with 95% CI, 1.34, 1.68) and developing (1. 36 with 95% CI, 1.13, 1.65) countries showed significant\r\nassociations. Moreover, there is an increased odds of inadequate antenatal care use among women with unintended\r\npregnancies as compared to women with intended pregnancies (OR 1.64, 95% CI: 1.47, 1.82). Subgroup analysis for\r\ndeveloped (OR, 1.86; 95% CI: 1.62, 2.14) and developing (OR, 1.54; 95% CI: 1.33, 1.77) countries also showed a statistically\r\nsignificant association. However, there were heterogeneities in the studies included in this analysis.\r\nConclusion: Unintended pregnancy is associated with late initiation and inadequate use of antenatal care services.\r\nHence, women who report an unintended pregnancy should be targeted for antenatal care counseling and services to\r\nprevent adverse maternal and perinatal outcomes. Moreover, providing information on the importance of planning and\r\nhealthy timing of pregnancies, and the means to do so, to all women of reproductive ages is essential.
Loading....