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IJE Advance Access published online on November 23, 2004
International Journal of Epidemiology, doi:10.1093/ije/dyh354
© 2004 by International Epidemiological Association
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Accepted September 14, 2004

Original paper

Parental pregnancy intention and early childhood stunting: findings from Bolivia

Carrie Shapiro-Mendoza 1*, Beatrice J Selwyn 1, David P Smith 1, and Maureen Sanderson 2

1 School of Public Health, University of Texas Health Science Center at Houston, TX, USA
2 School of Public Health, University of Texas Health Science Center at Brownsville, TX, USA

* To whom correspondence should be addressed.
Carrie Shapiro-Mendoza, E-mail: ayn9{at}cdc.gov


  Abstract

Background This study examined the impact of maternally reported pregnancy intention, differentiating unwanted and mistimed pregnancies, on the prevalence of early childhood stunting. Additionally, it examined the influence of paternal pregnancy intention status.

Methods Data were collected from a nationally representative sample of women and men interviewed in the 1998 Bolivia Demographic and Health Survey. The sample was restricted to lastborn, singleton children younger than 36 months who had complete anthropometric information. Multivariable logistic regression examined the association between pregnancy intention and stunting.

Results Children from unwanted and mistimed pregnancies comprised 33% and 21% of the sample, respectively. Approximately 29% of the maternally unwanted children were stunted as compared to 19% among intended and 19% among mistimed children. Children 12-35 months (toddlers) from mistimed pregnancies (adjusted prevalence risk ratio [PRadj] 1.33, 95% confidence interval [CI]: 1.03-1.72) and unwanted pregnancies (PRadj 1.28, 95% CI: 1.04-1.56) were at about a 30% greater risk for stunting than children from intended pregnancies. Infants and toddlers with both parents reporting them as unwanted had an increased risk of being stunted as compared with children both of whose parents intended the pregnancy. No association was found for infants less than 12 months.

Conclusions Reducing unintended pregnancies in Bolivia may decrease the prevalence of childhood growth stunting. Children born to parents reporting mistimed or unwanted pregnancies should be monitored for growth stunting, and appropriate interventions should be developed. Measurement of paternal pregnancy intention status is valuable in pregnancy intention studies.

Keywords: Bolivia; pregnancy; unwanted; family planning services; fertility; fathers; mothers; malnutrition.
A Commentary has been commissioned to accompany this paper and will appear in the print issue with this article.
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