Abstract
BACKGROUND: Unintended pregnancy occurs when an individual or couple conceives without planning or desire, which can potentially affect a child's physical, mental, and social well-being. This can then lead to long-term socioeconomic challenges for families and communities. Although its impact on child growth and development is a pressing concern, research remains limited particularly in multicenter settings. AIM: To examine the long-term consequences of unintended pregnancy on the critical years of early childhood growth and development. METHODS: This analytical observational study employed a case-control design and was conducted in research centers across Indonesia, encompassing those located in Central Java, Lampung, Bali, and West Nusa Tenggara. A total of 700 children aged ≤ 5 years with histories of intended or unintended pregnancies participated. Data collection involved structured interviews and direct anthropometric and developmental assessments. Data analyses were conducted using multivariate statistics and partial least squares structural equation modeling. RESULTS: Unintended pregnancy was found to have a statistically significant effect on both child growth (t = 8.178; P < 0.001) and child development (t = 25.688; P < 0.001). Key growth problems identified included underweight, undernutrition, abnormal head circumference, and stunting. Developmental challenges prominently associated with unintended pregnancy included behavioral and emotional disorders, autism spectrum disorder, attention-deficit/hyperactivity disorder, social and motor skill deficits, as well as visual and hearing impairments. CONCLUSION: Unintended pregnancy significantly affects child growth and development, underscoring the need for early intervention, quality prenatal care, and strengthened family planning policies.