Thesis Format
Monograph
Degree
Master of Science
Program
Epidemiology and Biostatistics
Supervisor
Thind, Amardeep
2nd Supervisor
Ryan, Bridget
Co-Supervisor
3rd Supervisor
Kandala, Ngianga-Bakwin
Co-Supervisor
Abstract
Background: Pakistan has the highest global pregnancy loss burden.
Methods: Separate urban and rural analyses were implemented to identify the community-level, sociodemographic, maternal, environmental, and health-services factors associated with pregnancy-loss-reporting in the 2019 Pakistan Maternal Mortality Survey. Mixed-effects negative binomial regression was employed.
Results: In full urban sample, pregnancy loss was associated with lower maternal education, increasing maternal age, marriage, and unimproved sanitation facilities. In urban subsample of recent pregnancies, pregnancy loss was associated with lower wealth index, increasing age, and inadequate antenatal visits. In full rural sample, region of residence, wealth status, increasing age, marriage, unimproved-drinking water, clean-cooking fuel, and open defecation was associated with pregnancy loss. In rural subsample of recent pregnancies, pregnancy loss was associated with region of residence, increasing age, and clean-cooking fuel.
Conclusion: These findings highlight the importance of understanding the urban-rural differences in Pakistan to inform targeted interventions and policies.
Summary for Lay Audience
Pregnancy loss, encompassing miscarriages and stillbirths, is a significant concern in low- and middle-income countries like Pakistan. The Lancet report on stillbirths ranked Pakistan as the country with the highest number of stillbirths in 2015, emphasizing the urgency to understand its predictors. This study aimed to uncover the predictors of pregnancy loss among women between the ages of 15 to 49, living in the urban and rural areas of Pakistan.
To investigate the factors associated with pregnancy loss, in urban and rural areas, we analyze data from the 2019 Pakistan Maternal Mortality Survey. This study also includes a specific subsample of women who had pregnancies between 2016 and 2019, where the impact of antenatal care usage is examined. We use several statistical models to understand the pregnancy loss factors in urban and rural areas separately, as well as separate models to understand the impact of antenatal care usage. From the analyses, within the urban full sample, pregnancy loss was associated with maternal education, maternal age, marital status, and type of toilet facility. Within the urban subsample, wealth index, maternal age, and antenatal care visits were associated with pregnancy loss. In the rural full sample, factors including region of residence, wealth index, maternal age, marital status, drinking water source, type of cooking fuel, and type of toilet facility were associated with pregnancy loss. Lastly, in the rural subsample, pregnancy loss was associated with region of residence, maternal age, and type of cooking fuel.
In conclusion, this study highlights the importance of understanding these urban-rural differences to inform targeted interventions and policies. By identifying the specific predictors for each area, policymakers can implement effective strategies to reduce the burden of pregnancy loss in Pakistan. The findings provide valuable insights for public health initiatives and policymakers to make strides towards reducing pregnancy loss in Pakistan.
Recommended Citation
George Samuel, Kevin, "The Predictors of Pregnancy Loss Among Women Aged 15-49 Years in Pakistan" (2024). Electronic Thesis and Dissertation Repository. 9945.
https://ir.lib.uwo.ca/etd/9945
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Included in
International Public Health Commons, Maternal and Child Health Commons, Women's Health Commons