School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
S Afr Med J. 2024 Jun 24;114(6b):e1241. doi: 10.7196/SAMJ.2024.v114i16b.1241.
Adverse pregnancy outcomes are an important indicator of the overall health of a population and the socioeconomic development of a country.
To determine the prevalence and factors associated with adverse pregnancy outcomes among women of reproductive age in South Africa, and to recommend strategies to reduce the burden of these outcomes.
We conducted a secondary data analysis on women of reproductive age using data from the nationally representative, population- based, cross-sectional 2016 South Africa Demographic and Health Survey (SADHS). We described the sociodemographic characteristics of the study participants and determined the prevalence and factors associated with adverse pregnancy outcomes using the multivariable logistic regression model. We adjusted all our analyses for complex survey sampling using survey weights.
There were 8 514 women of reproductive age, of whom 41.2% had fallen pregnant during the 5-year period preceding the survey. The majority (70.9%) were of age 20 - 34 years, 78% had secondary education, 61.6% were unemployed, 65% were from urban areas, and more than 40% of these women were currently living with a man, while 51.5% reported that they had never been in a union. The prevalence of adverse pregnancy outcomes was 14.6% (95% CI 13.2 - 16.1%). The odds of experiencing adverse pregnancy outcomes were significantly higher for those aged 35 - 49 years (adjusted odds ratio (aOR) 7.41, 95% CI 3.46 - 15.85) or 20 - 34 years (aOR 2.07, 95% CI 1.02 - 4.18), compared with those aged 15 - 19 years. Women who were currently in a union/living with a man (aOR 1.85, 95% CI 1.41 - 2.43) or formerly in a union/living with a man (aOR 2.66, 95% CI 1.64 - 4.29), compared with those who had never been in a union, had higher odds of adverse pregnancy outcomes. Contrarily, adverse pregnancy outcomes were lower with each additional child delivered or ever born (aOR 0.66, 95% CI 0.58 - 0.75).
We report a high prevalence of adverse pregnancy outcomes among women of reproductive age in South Africa. We recommend addressing factors such as maternal age and currently/formerly living with a man within interventions to reduce the burden of adverse pregnancy outcomes in South Africa.
不良妊娠结局是衡量人口整体健康水平和国家社会经济发展的重要指标。
确定南非育龄妇女不良妊娠结局的发生率及其相关因素，并提出降低这些结局负担的策略。
我们对全国代表性、基于人群的、横断面 2016 年南非人口与健康调查（SADHS）中的育龄妇女进行了二次数据分析。我们描述了研究参与者的社会人口统计学特征，并使用多变量逻辑回归模型确定了不良妊娠结局的发生率及其相关因素。我们使用调查权重对所有分析进行了复杂的调查抽样调整。
共有 8514 名育龄妇女，其中 41.2%在调查前 5 年内怀孕。大多数（70.9%）年龄在 20-34 岁之间，78%接受过中等教育，61.6%失业，65%来自城市地区，超过 40%的妇女目前与一名男子同居，而 51.5%的妇女报告从未结过婚。不良妊娠结局的发生率为 14.6%（95%CI 13.2-16.1%）。与 15-19 岁年龄组相比，35-49 岁（调整后的优势比[aOR] 7.41，95%CI 3.46-15.85）或 20-34 岁（aOR 2.07，95%CI 1.02-4.18）年龄组发生不良妊娠结局的可能性显著更高。目前处于婚姻/与男子同居（aOR 1.85，95%CI 1.41-2.43）或以前处于婚姻/与男子同居（aOR 2.66，95%CI 1.64-4.29）的妇女与从未结婚的妇女相比，发生不良妊娠结局的可能性更高。相反，每多生或多育一个孩子，不良妊娠结局的发生率就会降低（aOR 0.66，95%CI 0.58-0.75）。
我们报告了南非育龄妇女中不良妊娠结局的高发生率。我们建议在干预措施中解决产妇年龄和目前/以前与男子同居等因素，以降低南非不良妊娠结局的负担。
