Bayesian spatial analysis of socio-demographic factors influencing pregnancy termination and its residual geographic variation among ever-married women of reproductive age in Bangladesh

BMC Public Health. 2020 Sep 4;20(1):1348. doi: 10.1186/s12889-020-09401-1.

Abstract

Background: Unsafe pregnancy termination is a major public health concern among reproductive-aged women in many developing countries. This study evaluated the socio-demographic characteristics, as well as residual spatial correlation in pregnancy termination among Bangladeshi women.

Methods: Secondary data was obtained from the Bangladesh Demographic and Health Survey for the survey year 2014. Data included 17,863 samples of ever-married women between the ages of 15-49 years, which is a national representative sample in Bangladesh. Bayesian spatial logistic regression was used to assess the associations between socio-demographic characteristics and pregnancy termination. We flexibly modeled the non-linear effects of the continuous covariates while accounting for residual spatial correlation at the district level.

Results: Our findings revealed that about 19% of the respondents in Bangladesh reported ever had a pregnancy terminated. The risk of pregnancy termination was higher among women who had been working, had a higher wealth index, were in a conjugal relationship, had no children, were older and started their cohabitation earlier. Residual spatial patterns revealed the areas at a higher risk of pregnancy termination, including Panchagarh, Habiganj, and Sylhet after adjusting for covariates.

Conclusions: Prevalence of pregnancy termination remains considerably high in Bangladesh. The study revealed significant associations of women's age at survey time, age at first cohabitation, occupational status, socio-economic status, marital status and the total number of children ever born with reporting having a history of terminated pregnancy among Bangladeshi ever-married women. The identified socio-demographic characteristics and districts at an increased likelihood of pregnancy termination can inform localized intervention and prevention strategies to improve the reproductive healthcare of women in Bangladesh.

Keywords: Bangladesh; Bayesian logistic regression; Pregnancy termination; Reproductive health; Spatial analysis.

MeSH terms

  • Abortion, Induced / statistics & numerical data*
  • Adolescent
  • Adult
  • Bangladesh / epidemiology
  • Bayes Theorem
  • Employment
  • Family Characteristics
  • Family Conflict
  • Female
  • Humans
  • Logistic Models
  • Marital Status
  • Middle Aged
  • Models, Statistical
  • Pregnancy
  • Prevalence
  • Social Class
  • Socioeconomic Factors
  • Spatial Analysis
  • Young Adult