Maternal socio-demographic characteristics and foetal losses: An analysis of data from 2013/14 Zambia Demographic and Health Survey
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
Zambia-Statistics, Medical, Miscarriage-Zambia-Statistics, Prenatal Death-Statistics
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