Time-to-pregnancy and pregnancy outcomes in a South African population

Abstract

BackgroundTime-to-pregnancy (TTP) has never been studied in an African setting and there are no data on the rates of adverse pregnancy outcomes in South Africa. The study objectives were to measure TTP and the rates of adverse pregnancy outcomes in South Africa, and to determine the reliability of the questionnaire tool.MethodsThe study was cross-sectional and applied systematic stratified sampling to obtain a representative sample of reproductive age women for a South African population. Data on socio-demographic, work, health and reproductive variables were collected on 1121 women using a standardized questionnaire. A small number (n = 73) of randomly selected questionnaires was repeated to determine reliability of the questionnaire. Data was described using simple summary statistics while Kappa and intra-class correlation statistics were calculated for reliability.ResultsOf the 1121 women, 47 (4.2%) had never been pregnant. Mean gravidity was 2.3 while mean parity was 2.0 There were a total of 2467 pregnancies; most (87%) resulted in live births, 9.5% in spontaneous abortion and 2.2% in still births. The proportion of planned pregnancies was 39% and the median TTP was 6 months. The reliability of the questionnaire for TTP data was good; 63% for all participants and 97% when censored at 14 months. Overall reliability of reporting adverse pregnancy outcomes was very high, ranging from 90 - 98% for most outcomes.ConclusionThis is the first comprehensive population-based reproductive health study in South Africa, to describe the biologic fertility of the population, and provides rates for planned pregnancies and adverse pregnancy outcomes. The reliability of the study questionnaire was substantial, with most outcomes within 70 - 100% reliability index. The study provides important public information for health practitioners and researchers in reproductive health. It also highlights the need for public health intervention programmes and epidemiological research on biologic fertility and adverse pregnancy outcomes in the population.

The study of waiting time to first pregnancy in the south of Iran: A parametric frailty model approach

“…In a South African study, the median time to pregnancy in the population was six months, with 68% of women achieving pregnancy in the first year, which is similar to our study (9). This proportion is within the 67-85% range reported for five European countries in a multi-country population study (20).…”

“…The same study on TTP in South Africa showed that the proportion of planned pregnancies was 39% and the median TTP was 6 months (9). A cross-sectional study of time to first pregnancies was undertaken on Colombian women working in agricultural production (10).…”

“They must understand we are people”: Pregnancy and maternity service use among signing Deaf women in Cape Town

“…The average parity in our sample was similar to the regional rate for the Western Cape (32), which is consistent with findings that women with sensory disabilities do not have fewer children than non-disabled women (12). The proportion of women who experienced a miscarriage (31%), is higher than the 16% found in a population based study in South Africa (34). Due to the limitations of our sample, it is not clear whether this trend would be seen in a nationally representative sample of Deaf women.…”

Validity and reliability of maternal recall of pregnancy history and service use among signing Deaf women: a cross-sectional descriptive study from South Africa

“…For instance, the sample fertility rate of 1.72 was lower than the South African population rate of 2.40 (T. Moultrie, personal communication, March 18, 2016). The study also showed a higher rate of miscarriage of 31% for Deaf women versus 16% found in a population-based study in South Africa 13. These findings12 are consistent with other studies of pregnancy history in South Africa which shows that most women have received antennal care during pregnancy14 but that there is a delay in seeking care beyond the first trimester 15–17.…”