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Background and Objective <p>Unplanned pregnancy is a major public health issue associated with negative maternal and child health outcomes. Intimate partner violence (IPV) and socioeconomic inequalities are key predictors. This study aimed to analyze the prevalence and factors associated with unplanned pregnancy among women of childbearing age in Ceará, Brazil.</p> Methods <p>We conducted an analytical cross-sectional study using data from the 2023 Ceará Maternal and Child Health Survey (Pesmic). A total of 3,200 women aged 10–49 years were selected through multi-stage systematic sampling. The outcome was unplanned pregnancy. Independent variables were grouped into IPV-related factors, socioeconomic factors, and sexual/reproductive factors. We performed multivariate logistic regression; adjusted odds ratios (aOR) and 95% confidence intervals (CI) were reported.</p> Results <p>The prevalence of unplanned pregnancy was 31.8% (95%CI 30.0–33.6). In multivariate analysis, IPV emerged as a strong predictor (aOR = 2.2; 95%CI 1.6–3.1). Other independent risk factors included low education, not being in a stable union, food insecurity, and urban residence. Among reproductive factors, multiple sexual partners, history of STIs, never using hormonal contraceptives, ever use of IUD, and ever use of emergency contraception were significantly associated.</p> Conclusion <p>We found a high prevalence of unplanned pregnancy among women in Ceará. Intimate partner violence was a key risk factor, and multiple dimensions of socioeconomic vulnerability (low education, being single, food insecurity, urban marginalization) and certain reproductive behaviors (multiple partners, STI history, suboptimal contraception use, IUD or emergency contraception ever use) were independently associated. These findings highlight the need for integrated interventions that address violence prevention within reproductive health, reduce social inequalities, and improve education and access to consistent, effective contraceptive methods. Comprehensive policies strengthening women’s autonomy and ensuring safe reproductive choices – including access to safe, legal abortion when needed – are urgently required to reduce unplanned pregnancies and support women’s health in Ceará.</p>

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Prevalence and factors associated with unplanned pregnancy among women of childbearing age in Ceará, Brazil: a cross-sectional study with population representativeness

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  • 发表日期：

    2026年4月9日

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  • Anamerinda de O. Diaz,
  • Sabrina G. M. O. Rocha,
  • Luciano L. Correia,
  • Valbert O. Costa Filho,
  • Igor P. F. Romeiro,
  • Anamaria C. e Silva,
  • Jocileide S. Campos,
  • Dirlene M. I. Silveira,
  • Sâmia G. M. O. Giacomini,
  • Márcia M. T. Machado,
  • Hermano A. L. Rocha

摘要

Background and Objective

Unplanned pregnancy is a major public health issue associated with negative maternal and child health outcomes. Intimate partner violence (IPV) and socioeconomic inequalities are key predictors. This study aimed to analyze the prevalence and factors associated with unplanned pregnancy among women of childbearing age in Ceará, Brazil.

Methods

We conducted an analytical cross-sectional study using data from the 2023 Ceará Maternal and Child Health Survey (Pesmic). A total of 3,200 women aged 10–49 years were selected through multi-stage systematic sampling. The outcome was unplanned pregnancy. Independent variables were grouped into IPV-related factors, socioeconomic factors, and sexual/reproductive factors. We performed multivariate logistic regression; adjusted odds ratios (aOR) and 95% confidence intervals (CI) were reported.

Results

The prevalence of unplanned pregnancy was 31.8% (95%CI 30.0–33.6). In multivariate analysis, IPV emerged as a strong predictor (aOR = 2.2; 95%CI 1.6–3.1). Other independent risk factors included low education, not being in a stable union, food insecurity, and urban residence. Among reproductive factors, multiple sexual partners, history of STIs, never using hormonal contraceptives, ever use of IUD, and ever use of emergency contraception were significantly associated.

Conclusion

We found a high prevalence of unplanned pregnancy among women in Ceará. Intimate partner violence was a key risk factor, and multiple dimensions of socioeconomic vulnerability (low education, being single, food insecurity, urban marginalization) and certain reproductive behaviors (multiple partners, STI history, suboptimal contraception use, IUD or emergency contraception ever use) were independently associated. These findings highlight the need for integrated interventions that address violence prevention within reproductive health, reduce social inequalities, and improve education and access to consistent, effective contraceptive methods. Comprehensive policies strengthening women’s autonomy and ensuring safe reproductive choices – including access to safe, legal abortion when needed – are urgently required to reduce unplanned pregnancies and support women’s health in Ceará.