Maternal socio-demographic characteristics and foetal losses: An analysis of data from 2013/14 Zambia Demographic and Health Survey
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Date
2016
Authors
Chishimba, Paul
Journal Title
Journal ISSN
Volume Title
Publisher
University of Zambia
Abstract
OBJECTIVES: To determine social and demographic characteristics of mothers that were risk
factors for pregnancy losses and; assess the relative importance of respective socioeconomic
and demographic characteristics of mothers in determining the risk of losing a pregnancy
METHODOLOGY: This was a cross-sectional, quantitative design that used data from the
2013/14 ZDHS. Binary logistic regression models were fitted to the data to explore and
determine maternal factors associated with pregnancy losses among Zambian women aged
15-49. A total of 2399 cases were selected from the women’s questionnaire sub dataset. The
following variables were selected: Age of the mother, education, Body Mass Index, Children
ever born, Family planning use, marital status, STI symptoms and age at first child.
RESULTS: Ten and half percent of the women reported having lost a pregnancy in the 12
months before the interview and nearly 75 percent did so within three months of pregnancy.
When all variables were considered together, education and BMI, were not statistically
significantly (α=0.05). The older the woman (older than19 years) the higher the risk of
pregnancy loss, (OR=2.79; 95% CI, 1.45-5.35) for those aged 30-34, (OR=2.53; 95% CI,
1.50-4.29) for those aged 20-29 and (OR=2.51; 95% CI, 1.28-4.92) for those aged 35+. The
risk of losing a pregnancy reduced with increasing number of Children Ever born (CEB)
(OR=0.40; 95% CI, 0.21-0.74) for CEB=1, (OR=0.14; 95% CI, 0.07-0.28) for those with 5+
children. Having had STI symptoms, significantly increased twofold the odds of losing a
pregnancy (OR=2.33; 95% CI, 1.35-4.02). Women who had their first child from 17-19
years, were 32 percent less likely (OR=0.68; 95% CI, 0.47- 1.00) and those who started child
bearing after 19 years, were 54 percent less likely (OR=0.46; 95% CI, 0.29-0.73) to have lost
a pregnancy than those who had their first child before 17 years of age.
Women who were currently using a family planning (FP) method were about 34 percent less
(OR=0.66; 95% CI, 0.45-0.98), and those who had used a method before were about 86
percent more likely (OR=1.86; 95% CI, 1.28-2.68), to experience a pregnancy loss that those
who had never used any contraceptive method. Women who were currently leaving with a
partner, were 17 times more likely (OR=17.04; 95% CI, 4.24-68.45), while those who were
currently married were 13 times more likely (OR=13.03; 95% CI, 7.37-23.05) to experience a
pregnancy loss than those who had never been in a union. Those who were
separated/widowed/divorced were more likely to start FP immediately after pregnancy loss
(29.2% vs 19.3% for those in a union) while those in a union (married/cohabiting) were more
likely to fall pregnant again than those who were separated/widowed/divorced (22.8% vs
16.6%).
DISCUSSION AND CONCLUSION: This study provides indications in the patterns of pregnancy
losses in Zambia. Findings point to concerns raised in other studies on Zambia, that cases
usually reported as miscarriages are mostly induced as indicated by the higher tendency to
promptly turn to family planning after loss among those who were not in formal unions.
Increased access to family planning and screening for STIs may hold the key to reduced
incidence of pregnancy losses, as it is likely to promote delaying the timing at first child and
reduced length of exposure to syphilis during pregnancy as women in Zambia generally
report late for first prenatal visit
Description
M ARTS IN POPULATION STUDIES
Keywords
Zambia-Statistics, Medical , Miscarriage-Zambia-Statistics , Prenatal Death-Statistics