Bayesian spatial analysis of socio-demographic factors influencing pregnancy termination and its residual geographic var
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RESEARCH ARTICLE
Open Access
Bayesian spatial analysis of socio-demographic factors influencing pregnancy termination and its residual geographic variation among ever-married women of reproductive age in Bangladesh Rifat Zahan1 and Cindy Xin Feng2,3,4*
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: Pregnancy termination, Reproductive health, Spatial analysis, Bayesian logistic regression, Bangladesh
*Correspondence: [email protected] Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, 5790 University Avenue, B3H 4R2 Halifax, Nova Scotia, Canada 3 School of Public Health, University of Saskatchewan, 104 Clinic Place, S7N 2Z4 Saskatoon, Saskatchewan, Canada Full list of author information is available at the end of the article 2
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes wer
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