Reported patterns of pregnancy termination from Demographic and Health Surveys

Abstract

Introduction Demographic and Health Surveys, widely used for estimation of fertility and reproductive health indicators in developing countries, remain underutilized for the study of pregnancy termination. This is partly due to most surveys not reporting the type of pregnancy termination, whether spontaneous or induced. Reproductive calendar data makes it possible to examine termination patterns according to contraceptive use at the time of pregnancy. Contraceptive failure is expected to increase the likelihood of induced abortion helping in the interpretation of reported termination patterns. Materials and methods We use individual-level calendar data regarding 623,966 pregnancies to analyze levels and differentials in reported patterns of pregnancy termination by age, union status, and contraceptive use in 107 DHS surveys from 50 countries. From the estimates of the probability of pregnancy termination, we compute derived reproductive health indicators providing an assessment of what is driving the differences by comparison to the few surveys reporting the type of pregnancy termination. Results From our estimates, 10.9% of pregnancies do not end in live-birth and 63.7% of them are spontaneous terminations. Reported pregnancy termination is higher among women using contraceptives, consistent with expectations. Very low levels of reported PT in some countries, particularly in sub-Saharan Africa, suggests possible underreporting. Differential patterns emerging from cluster analysis and regional rates indicate high rates of pregnancy termination driven by induced abortion in countries from the Former Soviet Union and Asian countries with liberal laws. Most countries with restrictive abortion laws have low levels of reported termination. While the probabilities of pregnancy termination are higher at older ages, termination rates generally peak at younger ages due to higher conception rates. Discussion This is the first large comparative study of the patterns of reported pregnancy termination in DHS surveys. While we have explored the extent to which differences arise from spontaneous terminations or induced abortion, more research is needed regarding the determinants of reported pregnancy termination.

Modeling Risk Factors Associated With Time to Pregnancy Termination in Ethiopia: Application of Frailty Models

“…About 10.9% of pregnancies do not end in live-birth and about 63.7% of these pregnancies was terminated due to miscarriage. Based on reported it is higher among women using contraceptives, consistent with expectations and very low levels of reported in some countries, particularly in sub-Saharan Africa, suggests possible underreporting [3].…”

Intimate partner violence against adolescent girls and young women and its association with miscarriages, stillbirths and induced abortions in sub-Saharan Africa: Evidence from demographic and health surveys

“…Majority of induced abortions, stillbirths and miscarriages occur in low-and middle-income countries (LMICs) and the sub-Saharan African region ( Bearak et al, 2020 ). Studies have also found that the risk of pregnancy termination is high among adolescent girls and young women (AGYW) compared to older women ( Leppälahti, Gissler, Mentula, & Heikinheimo, 2012 ; Onukwugha, Magadi, Sarki, & Smith, 2020 ; Sánchez-Páez & Ortega, 2019 ). One of the major risk factors for pregnancy termination is intimate partner violence (IPV) ( Durevall & Lindskog, 2015 ).…”

<p>Synergistic Effect Between Full-Term Pregnancy/Breastfeeding And Familial Susceptibility On Breast Cancer Risk</p>

“…Terminal differentiation of the terminal ductal lobular unit occurs in the final trimester. Parity-related gene expression signatures in normal breast tissue have been identified in recent research 14. Experimental animal models have suggested the protective effect of full-term pregnancy 15–17.…”

“…History of breastfeeding was defined as more than 1 month of feeding baby with breast milk 13. Abortion was defined as termination of pregnancy during the first 28 weeks of pregnancy 14…”