Factors associated with pregnancy termination in women of childbearing age in 36 low-and middle-income countries.

Lack of access to safe, affordable, timely and adequate pregnancy termination care, and the stigma associated with abortion in low-middle income countries (LMICs), pose a serious risk to women's physical and mental well-being throughout the lifespan. Factors associated with pregnancy terminatio...

Full description

Bibliographic Details
Main Authors: Djibril M Ba, Yue Zhang, Omrana Pasha-Razzak, Chachrit Khunsriraksakul, Mamoudou Maiga, Vernon M Chinchilli, Paddy Ssentongo
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLOS Global Public Health
Online Access:https://doi.org/10.1371/journal.pgph.0001509
_version_ 1827826630619299840
author Djibril M Ba
Yue Zhang
Omrana Pasha-Razzak
Chachrit Khunsriraksakul
Mamoudou Maiga
Vernon M Chinchilli
Paddy Ssentongo
author_facet Djibril M Ba
Yue Zhang
Omrana Pasha-Razzak
Chachrit Khunsriraksakul
Mamoudou Maiga
Vernon M Chinchilli
Paddy Ssentongo
author_sort Djibril M Ba
collection DOAJ
description Lack of access to safe, affordable, timely and adequate pregnancy termination care, and the stigma associated with abortion in low-middle income countries (LMICs), pose a serious risk to women's physical and mental well-being throughout the lifespan. Factors associated with pregnancy termination and their heterogeneity across countries in LMICs previously have not been thoroughly investigated. We aim to determine the relative significance of factors associated with pregnancy termination in LMICs and its variation across countries. Analysis of cross-sectional nationally representative household surveys carried out in 36 LMICs from 2010 through 2018. The weighted population-based sample consisted of 1,236,330 women of childbearing aged 15-49 years from the Demographic and Health Surveys. The outcome of interest was self-report of having ever had a pregnancy terminated. We used multivariable logistic regression models to identify factors associated with pregnancy termination. The average pooled weighted prevalence of pregnancy termination in the present study was 13.3% (95% CI: 13.2%-13.4%), ranging from a low of 7.8 (95% CI: 7.2, 8.4%) in Namibia to 33.4% (95% CI: 32.0, 34.7%) in Pakistan. Being married showed the strongest association with pregnancy termination (adjusted OR, 2.94; 95% CI, 2.84-3.05; P < 0.001) compared to unmarried women. Women who had more than four children had higher odds of pregnancy termination (adjusted OR, 2.45; 95% CI, 2.33-2.56; P < 0.001). Moreover, increased age and having primary and secondary levels of education were associated with higher odds of pregnancy termination compared to no education. In this study, married women, having one or more living children, those of older age, and those with at least primary level of education were associated with pregnancy termination in these 36 LMICs. The findings highlighted the need of targeted public health intervention to reduce unintended pregnancies and unsafe abortions.
first_indexed 2024-03-12T03:14:21Z
format Article
id doaj.art-a045dd90bcf34dfa946279280ba15199
institution Directory Open Access Journal
issn 2767-3375
language English
last_indexed 2024-03-12T03:14:21Z
publishDate 2023-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLOS Global Public Health
spelling doaj.art-a045dd90bcf34dfa946279280ba151992023-09-03T14:12:37ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752023-01-0132e000150910.1371/journal.pgph.0001509Factors associated with pregnancy termination in women of childbearing age in 36 low-and middle-income countries.Djibril M BaYue ZhangOmrana Pasha-RazzakChachrit KhunsriraksakulMamoudou MaigaVernon M ChinchilliPaddy SsentongoLack of access to safe, affordable, timely and adequate pregnancy termination care, and the stigma associated with abortion in low-middle income countries (LMICs), pose a serious risk to women's physical and mental well-being throughout the lifespan. Factors associated with pregnancy termination and their heterogeneity across countries in LMICs previously have not been thoroughly investigated. We aim to determine the relative significance of factors associated with pregnancy termination in LMICs and its variation across countries. Analysis of cross-sectional nationally representative household surveys carried out in 36 LMICs from 2010 through 2018. The weighted population-based sample consisted of 1,236,330 women of childbearing aged 15-49 years from the Demographic and Health Surveys. The outcome of interest was self-report of having ever had a pregnancy terminated. We used multivariable logistic regression models to identify factors associated with pregnancy termination. The average pooled weighted prevalence of pregnancy termination in the present study was 13.3% (95% CI: 13.2%-13.4%), ranging from a low of 7.8 (95% CI: 7.2, 8.4%) in Namibia to 33.4% (95% CI: 32.0, 34.7%) in Pakistan. Being married showed the strongest association with pregnancy termination (adjusted OR, 2.94; 95% CI, 2.84-3.05; P < 0.001) compared to unmarried women. Women who had more than four children had higher odds of pregnancy termination (adjusted OR, 2.45; 95% CI, 2.33-2.56; P < 0.001). Moreover, increased age and having primary and secondary levels of education were associated with higher odds of pregnancy termination compared to no education. In this study, married women, having one or more living children, those of older age, and those with at least primary level of education were associated with pregnancy termination in these 36 LMICs. The findings highlighted the need of targeted public health intervention to reduce unintended pregnancies and unsafe abortions.https://doi.org/10.1371/journal.pgph.0001509
spellingShingle Djibril M Ba
Yue Zhang
Omrana Pasha-Razzak
Chachrit Khunsriraksakul
Mamoudou Maiga
Vernon M Chinchilli
Paddy Ssentongo
Factors associated with pregnancy termination in women of childbearing age in 36 low-and middle-income countries.
PLOS Global Public Health
title Factors associated with pregnancy termination in women of childbearing age in 36 low-and middle-income countries.
title_full Factors associated with pregnancy termination in women of childbearing age in 36 low-and middle-income countries.
title_fullStr Factors associated with pregnancy termination in women of childbearing age in 36 low-and middle-income countries.
title_full_unstemmed Factors associated with pregnancy termination in women of childbearing age in 36 low-and middle-income countries.
title_short Factors associated with pregnancy termination in women of childbearing age in 36 low-and middle-income countries.
title_sort factors associated with pregnancy termination in women of childbearing age in 36 low and middle income countries
url https://doi.org/10.1371/journal.pgph.0001509
work_keys_str_mv AT djibrilmba factorsassociatedwithpregnancyterminationinwomenofchildbearingagein36lowandmiddleincomecountries
AT yuezhang factorsassociatedwithpregnancyterminationinwomenofchildbearingagein36lowandmiddleincomecountries
AT omranapasharazzak factorsassociatedwithpregnancyterminationinwomenofchildbearingagein36lowandmiddleincomecountries
AT chachritkhunsriraksakul factorsassociatedwithpregnancyterminationinwomenofchildbearingagein36lowandmiddleincomecountries
AT mamoudoumaiga factorsassociatedwithpregnancyterminationinwomenofchildbearingagein36lowandmiddleincomecountries
AT vernonmchinchilli factorsassociatedwithpregnancyterminationinwomenofchildbearingagein36lowandmiddleincomecountries
AT paddyssentongo factorsassociatedwithpregnancyterminationinwomenofchildbearingagein36lowandmiddleincomecountries