Evidence map›Paper›PMID 29519649›Full record

ArticleThe Lancet. Global health2018

Global, regional, and subregional trends in unintended pregnancy and its outcomes from 1990 to 2014: estimates from a Bayesian hierarchical model.

Jonathan Bearak, Anna Popinchalk, Leontine Alkema, Gilda Sedgh

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Global health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06711354 (B-cell Depletion in Offspring to Women With MS and Rituximab Treatment Before or During Pregnancy), which is not on this map. Cited by 320 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
320citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06711354 unknown statusnot on this mapstarted 2025, after this paper: background citation

B-cell Depletion in Offspring to Women With MS and Rituximab Treatment Before or During Pregnancy

Typeobservational_patient_registrySponsorRegion StockholmRan2025 to 2025Enrolled111ConditionsMultiple Sclerosis, B-Cell Deficiency, Offspring, Adult, ImmunosuppressionArmsAnti-CD20 Monoclonal Antibody
3 · Its place in the literature

Who cites it

320 citing papers in PubMed, 9 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Trial
  11. Trial
  12. Trial
  13. Article
  14. Article
  15. Review
  16. Review
  17. Article
  18. Article
  19. Article
  20. Article

260 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors.

Jonathan BearakGuttmacher Institute, New York, NY, USA. Electronic address: jbearak@guttmacher.org.
Anna PopinchalkGuttmacher Institute, New York, NY, USA.
Leontine AlkemaUniversity of Massachusetts-Amherst, Amherst, MA, USA.
Gilda SedghGuttmacher Institute, New York, NY, USA.

Funding

Research Infrastructure for Demographic and Behavioral Population Science Dissemination CoreR24HD074034 · NICHD · GUTTMACHER INSTITUTE · PI FINER, LAWRENCE B · 2013 to 2017
$462k
NICHD NIH HHS R24 HD074034
6 · The paper itself

Abstract

backgroundEstimates of pregnancy incidence by intention status and outcome indicate how effectively women and couples are able to fulfil their childbearing aspirations, and can be used to monitor the impact of family-planning programmes. We estimate global, regional, and subregional pregnancy rates by intention status and outcome for 1990-2014.

methodsWe developed a Bayesian hierarchical time series model whereby the unintended pregnancy rate is a function of the distribution of women across subgroups defined by marital status and contraceptive need and use, and of the risk of unintended pregnancy in each subgroup. Data included numbers of births and of women estimated by the UN Population Division, recently published abortion incidence estimates, and findings from surveys of women on the percentage of births or pregnancies that were unintended. Some 298 datapoints on the intention status of births or pregnancies were obtained for 105 countries.

findingsWorldwide, an estimated 44% (90% uncertainty interval [UI] 42-48) of pregnancies were unintended in 2010-14. The unintended pregnancy rate declined by 30% (90% UI 21-39) in developed regions, from 64 (59-81) per 1000 women aged 15-44 years in 1990-94 to 45 (42-56) in 2010-14. In developing regions, the unintended pregnancy rate fell 16% (90% UI 5-24), from 77 (74-88) per 1000 women aged 15-44 years to 65 (62-76). Whereas the decline in the unintended pregnancy rate in developed regions coincided with a declining abortion rate, the decline in developing regions coincided with a declining unintended birth rate. In 2010-14, 59% (90% UI 54-65) of unintended pregnancies ended in abortion in developed regions, as did 55% (52-60) of unintended pregnancies in developing regions.

interpretationThe unintended pregnancy rate remains substantially higher in developing regions than in developed regions. Sexual and reproductive health services are needed to help women avoid unintended pregnancies, and to ensure healthy outcomes for those who do experience such pregnancies.

fundingDutch Ministry of Foreign Affairs and UK Aid from the UK Government.

Indexed as

Pregnancy OutcomePregnancy, UnplannedAdolescentAdultBayes TheoremDeveloped CountriesDeveloping CountriesFemaleHumansModels, StatisticalPregnancyYoung Adult

Identifiers

PMID29519649
PMCPMC6055480

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.