Abstract
BACKGROUND: Limited attention has been paid to the characteristics of unintended pregnancy and prenatal depressive symptoms in China. This study aimed to explore the prevalence of and factors associated with unintended pregnancy and their impact on depressive symptoms among pregnant women in Guangdong, China. METHODS: A multicentre cross-sectional study was conducted among pregnant women attending routine antenatal care at five tertiary hospitals in Guangdong between February and July 2022. Pregnancy intention was assessed using a dichotomous question, and prenatal depressive symptoms were evaluated with the Edinburgh Postpartum Depression Scale (EPDS). Binary logistic regression was used to analyse the association between them. Stratified and sensitivity analyses were performed to test the robustness of the results. RESULTS: A total of 2120 pregnant women were included in the study, with an overall prevalence of unintended pregnancy of 34.6%. Factors associated with an increased risk of unintended pregnancy included being unemployed (OR = 1.43, 95%CI = 1.05-1.96), while factors associated with a decreased risk included: being 30-34 years old (OR = 0.73, 95%CI = 0.54-0.99), having siblings (OR = 0.60, 95%CI = 0.44-0.81), being married (OR = 0.31, 95%CI = 0.16-0.60), having a postgraduate degree (OR = 0.29, 95%CI = 0.14-0.59), not drinking alcohol (OR = 0.41, 95%CI = 0.23-0.74), and having never given birth (OR = 0.46, 95%CI = 0.37-0.56). After controlling for confounders, unintended pregnancy still had an impact on prenatal depressive symptoms (adjusted OR = 1.26, 95%CI = 1.03-1.52), more pronounced in pregnant women aged 20-29. CONCLUSIONS: Targeted screening for unintended pregnancy based on these associated factors and mental health support for high-risk groups could mitigate the risk of prenatal depressive symptoms.