Abstract
BackgroundUnsafe pregnancy termination is a major public health concern among reproductive-aged women in many developing countries. This study evaluated the socio-demographic characteristics, as well as residual spatial correlation in pregnancy termination among Bangladeshi women.MethodsSecondary data was obtained from the Bangladesh Demographic and Health Survey for the survey year 2014. Data included 17,863 samples of ever-married women between the ages of 15-49 years, which is a national representative sample in Bangladesh. Bayesian spatial logistic regression was used to assess the associations between socio-demographic characteristics and pregnancy termination. We flexibly modeled the non-linear effects of the continuous covariates while accounting for residual spatial correlation at the district level.ResultsOur findings revealed that about 19% of the respondents in Bangladesh reported ever had a pregnancy terminated. The risk of pregnancy termination was higher among women who had been working, had a higher wealth index, were in a conjugal relationship, had no children, were older and started their cohabitation earlier. Residual spatial patterns revealed the areas at a higher risk of pregnancy termination, including Panchagarh, Habiganj, and Sylhet after adjusting for covariates.ConclusionsPrevalence of pregnancy termination remains considerably high in Bangladesh. The study revealed significant associations of women’s age at survey time, age at first cohabitation, occupational status, socio-economic status, marital status and the total number of children ever born with reporting having a history of terminated pregnancy among Bangladeshi ever-married women. The identified socio-demographic characteristics and districts at an increased likelihood of pregnancy termination can inform localized intervention and prevention strategies to improve the reproductive healthcare of women in Bangladesh.
Highlights
Unsafe pregnancy termination is a major public health concern among reproductive-aged women in many developing countries
Effect of misspecification of non-linear covariate effects We examined the impact of misspecifying the covariate effects by comparing the estimated regression coefficients of the conditional autoregression (CAR) models for modeling the age variables having linear effect vs. non-linear effect using RW1
The results from our study suggested that women who were involved in any occupation were at an increased risk of reported pregnancy termination in Bangladesh
Summary
Unsafe pregnancy termination is a major public health concern among reproductive-aged women in many developing countries. Pregnancy termination can happen in the form of abortion, miscarriage, menstrual regulation and stillbirth. Between the year of 2010 and 2014, about 55.7 millions termination of pregnancies in the form of abortions occurred annually worldwide [2], where 88% of them were from developing countries. In 2014, about 1,194,000 induced abortions occurred in Bangladesh [4], whereas, 430,000 menstrual regulations (MR) were performed nationwide at the same year [5]. Unsafe termination of pregnancy is one of the determinants of maternal health complexity [6], maternal mortality, and morbidity [7] and is a significant public health concern in many developing countries [8]
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