Hijam Meena, Singh Khangembam Jitenkumar, Haobijam Sharatchandra, Alee Nongzaimayum Tawfeeq, Rozer Nandeibam Alfred, Singh Haobijam Nirendrakumar, Naorem Arun, Gonmei Pouningai
Project Technical Officer, Department of Community Medicine, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur India.
Scientist E, ICMR, New Delhi, Ansari Nagar, New Delhi, India.
J Obstet Gynaecol India. 2025 Apr;75(Suppl 1):457-465. doi: 10.1007/s13224-024-02073-6. Epub 2024 Nov 18.
Pregnancy-related deaths and complications have remained unacceptably high, particularly in low- and middle-income countries. Manipur is the most prevalent state for pregnancy wastage in India with an increasing trend over the last two decades.
The study aims to explore the level, pattern, spatial clustering, and determinants of pregnancy wastage in Manipur.
We utilized the NFHS-4 (2015-2016) and NFHS-5(2019-2021) data of Manipur. The Getis-OrdGi* spatial statistical tool was used to identify the hotspots clusters. Bayesian logistic regression analysis was applied to identify the determinants of pregnancy wastage.
The major hotspot clusters for pregnancy wastage were found in the valley districts, namely Imphal East, Imphal West, Thoubal, and Bishnupur. Further, a significant decline in hotspot clusters can be seen in the last five years. BMI was found to be a significant determinant for both abortion and miscarriage. Education, working status, number of antenatal care visits, wealth index and use of smokeless tobacco were associated with higher risks of having abortion among women.
The results highlight the need to develop district- centric antenatal care services to reduce the risk of pregnancy-related complications. Intervention should be tailored according to the life style choices and unique cultural practices of women in Manipur, India. It may also be beneficial to study the factors associated with declining hotspot clusters in some districts of Manipur.
与妊娠相关的死亡和并发症一直居高不下，令人难以接受，尤其是在低收入和中等收入国家。曼尼普尔邦是印度妊娠流产最普遍的邦，在过去二十年中呈上升趋势。
本研究旨在探讨曼尼普尔邦妊娠流产的水平、模式、空间聚集情况及决定因素。
我们利用了曼尼普尔邦的第四次全国家庭健康调查（NFHS-4，2015 - 2016年）和第五次全国家庭健康调查（NFHS-5，2019 - 2021年）的数据。使用Getis-Ord Gi*空间统计工具来识别热点集群。应用贝叶斯逻辑回归分析来确定妊娠流产的决定因素。
妊娠流产的主要热点集群位于山谷地区，即东因帕尔、西因帕尔、 Thoubal和比什努布尔。此外，在过去五年中热点集群数量显著下降。发现体重指数是堕胎和流产的一个重要决定因素。教育程度、工作状况、产前检查次数、财富指数和无烟烟草的使用与女性堕胎风险较高有关。
研究结果强调需要制定以地区为中心的产前护理服务，以降低与妊娠相关并发症的风险。干预措施应根据印度曼尼普尔邦女性的生活方式选择和独特文化习俗进行调整。研究曼尼普尔邦某些地区热点集群数量下降的相关因素可能也有益处。
