Statistics Discipline, Khulna University, Khulna, Bangladesh.
Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia.
PLoS One. 2021 Feb 1;16(2):e0245923. doi: 10.1371/journal.pone.0245923. eCollection 2021.
Unintended pregnancy is a significant public health concern in South Asian countries because of its negative association with the socioeconomic and health outcomes for both children and mothers. The present study aimed to explore the prevalence of unintended pregnancy and explore its determinants among women of reproductive age in six South Asian countries.
Nationwide latest demography and health survey data from six South Asian countries, including Bangladesh (2014), Pakistan (2017-2018), Nepal (2016), Afghanistan (2015), Maldives (2016-2017) and India (2015-2016) were pooled for the present study. Multivariate analysis was performed to explore the association between unintended pregnancy and its associated factors.
Amongst the total women (n = 41,689), overall, 19.1% pregnancies were reported as unintended (ranging from 11.9% in India to 28.4% in Bangladesh). The logistic regression model showed that younger women (15-19 years) had 1.42 times higher chance of unintended pregnancies. The odds of unintended pregnancies was 1.24 times higher for poorest women and 1.19 times higher for poorer women. Further, urban women (aOR = 0.70, 95% CI = 0.50-0.80), women having no children (aOR = 0.10, 95% CI = 0.09-0.12), smaller (≤4) family (aOR = 0.72, 95% CI = 0.67-0.78), those who intent to use contraceptive (aOR = 0.72, 95% CI = 0.60-0.86), currently living with partner (aOR = 0.90, 95% CI = 0.81-0.99), first cohabitation in teenage (≤19 years) (aOR = 0.85, 95% CI = 0.78-0.92) were less likely to report unintended pregnancies.
This study has showed that women's age, wealth index, place of residence, number of children, family size, the intention of contraceptive use, living with a partner, and first cohabitation age are essential determinants of unintended pregnancy. These factors should be considered when trying to reduce unintended pregnancy in six South Asian countries. However, there is a need to improve health education, counselling, skills-building, sex education, modern contraceptive use and its access in this region. Intervention programs regarding reproductive health and policies are warranted to reduce rates of unintended pregnancy in South Asian countries.
由于意外妊娠与儿童和母亲的社会经济和健康结局密切相关,因此它是南亚国家的一个重大公共卫生问题。本研究旨在探讨南亚六个国家育龄妇女意外妊娠的流行情况,并探讨其决定因素。
本研究纳入了来自南亚六个国家(孟加拉国[2014 年]、巴基斯坦[2017-2018 年]、尼泊尔[2016 年]、阿富汗[2015 年]、马尔代夫[2016-2017 年]和印度[2015-2016 年])最新的全国人口和健康调查数据。采用多变量分析探讨意外妊娠与相关因素之间的关系。
在所有女性(n=41689)中,总体上有 19.1%的妊娠被报告为意外妊娠(范围为印度的 11.9%至孟加拉国的 28.4%)。逻辑回归模型显示,年轻女性(15-19 岁)意外妊娠的可能性高 1.42 倍。最贫困的女性发生意外妊娠的可能性高 1.24 倍,较贫困的女性高 1.19 倍。此外,城市女性(aOR=0.70,95%CI=0.50-0.80)、无子女的女性(aOR=0.10,95%CI=0.09-0.12)、家庭规模较小(≤4 人)(aOR=0.72,95%CI=0.67-0.78)、打算使用避孕药具的女性(aOR=0.72,95%CI=0.60-0.86)、目前与伴侣同居的女性(aOR=0.90,95%CI=0.81-0.99)、首次同居年龄在青少年期(≤19 岁)的女性(aOR=0.85,95%CI=0.78-0.92),这些女性报告意外妊娠的可能性较低。
本研究表明,南亚六国妇女的年龄、财富指数、居住地、子女数量、家庭规模、避孕意愿、与伴侣同居以及初次同居年龄是意外妊娠的重要决定因素。在试图降低南亚六国意外妊娠率时,应考虑这些因素。然而,该地区需要改善生殖健康教育、咨询、技能建设、性教育、现代避孕药具的使用及其可及性。需要开展生殖健康干预计划和政策,以降低南亚国家的意外妊娠率。