Effect of contraception uptake on pregnancy outcomes among young women: evidence from the Indian demographic health surveys.

BACKGROUND

Several risk factors contributing to pregnancy outcomes among young women have been witnessed. It is well established that contraception plays a foremost role in reducing maternal mortality, obviously linked to pregnancy outcomes. Little is known about the impact of contraception uptake on pregnancy outcomes in the Indian context. Thus, this paper aimed to examine the effect of type of contraception on pregnancy outcomes among young married women aged 15-24 years.

METHODS

Data was extracted from the 2015-16 and 2019-21 National Family Health Survey (NFHS). The main outcome measure was pregnancy outcomes (live birth, abortion, miscarriage and stillbirth). Type of contraception uptake (no contraception, Short-Acting Reversible Contraceptives (SARCs), Long-Acting Reversible Contraceptives (LARCs) and permanent methods) was considered as the key exposure variable. To fulfil the study objective, cross-tabulations, chi-squared tests, and multinomial logistic regression models were employed.

RESULTS

During 2015-16-2019-21, the prevalence of live birth declined by 5.74%, whereas the proportion of miscarriage, abortion and stillbirth increased by 4.87%, 0.79% and 0.06%, respectively. Results from the multinomial models revealed that the association between type of contraception and pregnancy outcomes were strongly significant, even after adjusting for many other potential correlates. The results further found that the likelihood of abortion, miscarriage and stillbirth were significantly lower among young women using SARCs and markedly lower among women using LARCs methods, compared to no contraception use. Besides, women's age group, body mass index, height, haemoglobin level, parity, antenatal visits, place and mode of delivery, desire for more children, pregnancy intentions, distance to a nearest health facility, education level, social group, wealth quintile place and region of residence were also significantly associated with pregnancy outcomes.

CONCLUSIONS

The findings from this paper reinforced the need of the hour for implementing effective policies and adverse pregnancy prevention strategies towards ensuring access to the most effective contraception and underscore the importance of scaling up the quality of family planning services and health education that could lead to achieving the best possible pregnancy outcomes among young women.