Abstract
A multicenter cohort study was designed to assess pregnancy outcome among natural family planning (NFP) users, and provide the opportunity to address complications in NFP users by planning status and by timing of conception with respect to day of ovulation. There were 877 singleton births in this sample. Complications evaluated were abnormal vaginal bleeding, urinary tract infection, vaginal infection, hypertension of pregnancy, proteinuria, glycosuria, and anemia.
There was no significant difference in the mean age, number of prenatal visits or birth weight among optimally and non-optimally timed pregnancies or for planned and unplanned pregnancies. There were higher incidences of "parity 2 or more" and current smokers in the non-optimally timed pregnancies and lower incidences of prior pregnancy loss and "currently employed" in the non-optimally timed pregnancies. There was little difference in pregnancy complications with respect to pregnancy timing, with the exception of a significant increased risk of vaginal bleeding late in pregnancy among non-optimally timed conceptions (11.5%) compared to optimally timed pregnancies (5.2%, RR = 2.2, 95% CI 1.3-3.7).
More differences were observed in pregnancy complication rates by planning status. Unplanned pregnancies were associated with significantly more late pregnancy bleeding, vaginal infections, proteinuria, glycosuria and medication use than planned pregnancies. Unplanned pregnancies had lower incidences of maternal anemia.
Complications of pregnancy were low in this NFP population, irrespective of planned versus unplanned status. Women with planned pregnancies had even fewer complications during pregnancy than women with unplanned conceptions, suggesting that women using NFP to plan their reproduction may be at particularly low risk.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Gray RH, Simpson JL, Kambic RT et al. Timing of conception and the risk of spontaneous abortion among pregnancies occurring during use of natural family planning. Am J Obstet Gynecol. 1995; 172: 1567–72.
Simpson JL, Gray RH, Queenan JT et al. Pregnancy outcome associated with natural family planning (NFP): scienti¢c basis and experimental design for an international cohort study. Adv Contracept. 1988; 4: 247–64.
Simpson JL, Gray RH, Queenan JT et al. Fetal outcome among pregnancies in natural family planning acceptors: An international cohort study. Am J Obstet Gynecol. 1991; 165(Suppl): 1981–2.
Simpson JL, Bitto AC et al. Sex ratio with timing of conception and length of the follicular phase in planned and unplanned pregnancies during use of natural family planning. Human Reprod. [Sub-mitted].
Bitto A, Gray RH, Simpson JL et al. A prospective study of pregnancy outcomes among planned and unplanned pregnancies in natural family planning users. Am J Public Health. 1997; 87: 338–43.
Barbato M, Bitto A, Gray RH et al. E¡ects of timing of conception on birth weight and preterm delivery in natural family planning users. Adv Contracept. 1997; 13: 215–28.
German J. Mongolism, delayed fertilization and human sexual behavior. Nature (London). 1968; 219: 279–80.
World Health Organization. Manual of the International Statistica: Classi¢cation of Diseases, Injuries and Causes of Death. 1975 (9th revision).Volumes 1 and 2, World Health Organization, Geneva.
Kambic R, Gray RH. Interobserver variation in estimation of conception intercourse using selected natural family planning charts. Fertil Steril. 1989; 51: 430–4.
Guerrero R, Rojas OI. Spontaneous abortion and aging of human ova and spermatozoa. N Engl J Med. 1975; 293: 573–5.
Barrett JC, Marshall J. The risk of conception on di¡erent days of the menstrual cycle. Popul Stud. 1969; 59: 867–74.
Royston JP. Basal body temperature, ovulation and the risk of conception with special reference to the lifetimes of sperm and egg. Biometrics. 1982; 38: 397–406.
Wilcox AJ, Weinberg CR, Barid DD. Timing of sexual intercourse in relation to ovulation-e¡ects on the probability of conception, survival of the pregnancy and sex of the baby. N Engl JMed. 1995; 333: 1517–21.
Simpson JL. Pregnancy and timing of intercourse. N Engl J Med. 1995; 333: 1563–4.
Simpson JL, Gray RH, Queenan JT et al. Timing of intercourse. (Letter to the Editor). Human Reprod. 1995; 10: 2176–7.
Fleiss JL. Statistical Methods for Rates and Proportions. New York: John Wiley and Sons, 1981.
Armitage P, Berry G. Statistical Methods in Medical Research. Oxford: Blackwell Scienti¢c Publications, 1987.
Hosmer DW, Lemeshow S. Applied Logistic Regression. New York: John Wiley and Sons, 1989.
Rights and permissions
About this article
Cite this article
Mena, P., Bitto, A., Barbato, M. et al. Pregnancy complications in natural family planning users. Advances in Contraception 13, 229–237 (1997). https://doi.org/10.1023/A:1006560123036
Issue Date:
DOI: https://doi.org/10.1023/A:1006560123036