Unintended pregnancy and its impact on childhood rotavirus immunization in Peru

OBJECTIVE: To examine the association between unintended pregnancy and inadequate rotavirus immunization in Peruvian children. METHODS: Utilizing cross-sectional observational data from the 2012 Demographic and Health Survey (DHS), logistic regression analysis was used to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association between unintended pregnancy and inadequate rotavirus immunization among children. RESULTS: Of 9 620 pregnancies in the five years preceding the survey, 5 396 of them (56.1%) were reported as unintended, of which 2 981 were mistimed (30.9%) and 2 415 (25.1%) were unwanted. A total of 5 187 children (54.9%; 95% CI = 53.8%–56.1%) were recorded to have inadequate rotavirus immunization. Maternal literacy status was found to be a significant effect modifier of the association between pregnancy intention and rotavirus immunization (P value = 0.006). Among children born to illiterate mothers, unintended pregnancy was significantly associated with increased odds of inadequate rotavirus immunization (aOR = 2.6; 95% CI = 1.2–4.4), as compared to children from intended pregnancies. Deficient rotavirus immunization was significantly predicted by inadequate polio, pneumococcal, and influenza vaccinations; having a television in the household; and less maternal education. In contrast, having received breast-feeding education was protective against inadequate rotavirus immunization. Among literate mothers, there was no association between pregnancy intention and rotavirus immunization. CONCLUSION: Our study provides evidence that improving literacy among mothers could increase rotavirus vaccination uptake among children from unintended pregnancies.