Irish Medical Organisation

Rural background and age are found to be key factors in concealed pregnancies study

Irish Medical Journal Press Release

September 2012 - Volume 105 - Number 8

Rural background and age are found to be key factors in concealed pregnancies study

Despite societal changes and increased support mechanisms concealed pregnancies still occur, according to a study published in the latest edition of the Irish Medical Journal. Research from University Hospital Galway and HSE West reveals prevalence and reasons for concealed pregnancies.

Authors Clare Thynne et al said “Our retrospective study found 58% of the cases had concealed pregnancy right up to delivery and that one in every 148 births was a concealed pregnancy. This high rate of prevalence from University Hospital Galway is greater than any other Irish maternity hospital study”.

In Clinical practice, it is not uncommon that a pregnancy remains unrecognised up to the end of the first trimester. However, from the point of view of obstetric practice a pregnancy that remains un-booked is the second and third trimester is considered highly unusual and can pose a sever there to the life and health of the child and mother involved.

Reported rishks to an infant who does not receive a antenatal care are, prematurity, lower birth weight, an increase likelihood of being admitted to neonatal unit and a higher peri-natal mortality rate.

Women from a rural background and women in their early twenties are predominantly more likely to conceal their pregnancy according to the study published in September’s Irish Medical Journal.

The comparative study was carried out amongst a target group of women who concealed their pregnancy and an aged-matched control group that experienced a crisis pregnancy. The criteria for inclusion in the target group defined a concealed pregnancy as a woman who presents for antenatal care past 20 weeks gestation not having disclosed her pregnancy to her social network.

The authors noted of particular interest the recurrence of concealed pregnancies. Of nine women who had previously given birth, seven were found to conceal a second pregnancy.

Perceived family reaction was found to be one of the greatest reasons for concealing pregnancy. Primary findings include:

  • 79% of women from the target group feared a negative parental reaction compared to 40% of the control group.
  • 58% of the target group disclosed their pregnancy post-delivery
  • 30% were ‘unbooked’ (no antenatal sessions with trained personnel before presenting for labour). All of the pregnancies in the control group were booked and had disclosed their pregnancies prior to 20 weeks gestation.

“Fear of family reaction to a pregnancy seems to be a reality for women of various ages and not just a fear that exists during the teenage years”, according to Thynne et al. This supports the contention that concealed pregnancy is not exclusively a teenage phenomenon. In this instance women who concealed their pregnancy were predominately single and tended to be educated and in employment or in an educational setting.

As well as clinical implications for medical practitioners working in Ireland, these discoveries raise concerns for infant health and development, along with that of the mother. Further research on rural origin and societal factors to clarify the prevalence rates of concealed pregnancies is recommended by the authors.

All references and author names are contained in the full article in this month’s IMJ, p.263:
Title: “Concealed Pregnancy: Prevalence, Peri-Natal Measures and Socio-Demographics”

For further information contact:
Communications Unit
Irish Medical Organisation
Tel. 01 676 7273

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