ABSTRACT
Background & objectives: A substantial proportion of pregnant women in India are at the risk of serious obstetric complications and reliable information on obstetric morbidity is scanty, particularly in socio-economically disadvantaged society. We studied the association between the obstetric complications in women in their current pregnancy and adverse pregnancy outcomes in previous pregnancies in Uttar Pradesh, India. Methods: Data from District Level Household Survey (2007-2008) were used for empirical assessment. Bivariate, trivariate and Cox proportional hazard regression model analyses were applied to examine the effect of obstetric complications and previous pregnancy outcome on current pregnancy outcome among currently married women (age group 15-49 yr) in Uttar Pradesh, India. Results: The results of this study showed that the obstetric complications in the current pregnancy and adverse pregnancy outcomes in previous pregnancies were associated with the outcome of the current pregnancy. Cox proportional hazard regression model estimates revealed that the hazard ratio of having stillbirths were significantly higher among women with any obstetric complications compared to women with no obstetric complications. The adverse pregnancy outcome in a previous pregnancy was the largest risk factor for likelihood of developing similar type of adverse pregnancy outcome in the current pregnancy. Interpretation & conclusions: The findings provided key insights for health policy interventions in terms of prevention of obstetric complications to avoid the adverse pregnancy outcome in women.
ABSTRACT
Background & objectives: The ambiguity and variability in existing literature on the magnitude of socio-economic inequality in self-reported morbidities makes it difficult to set priorities in health policy. This study examined three critical research questions: first, how far self-reporting affects measuring socio-economic inequalities in case of obstetric morbidities. Second, does using simple bivariate variations mislead in estimating socio-economic differentials in prevalence of obstetric morbidities? Finally, whether use of sophisticated regression based decomposition results can overcome such problems. Methods: The data from National Family Health Survey (NFHS-3; 2005-06) were used, and analyzed by statistical tools such as bivariate estimates and regression based decomposition analysis. Results: Bivariate results revealed that self-reported obstetric morbidity data were misleading in measurement of socio-economic differentials, as these failed to show existing socio-economic variations in obstetric morbidities by socio-economic standing of women. However, decomposition analysis showed that the prevalence of obstetric complications was greater among socioeconomically disadvantaged groups. Interpretation & conclusions: Based on our findings on measurement of socio-economic inequality in self-reported obstetric morbidity, we conclude that the use of regression based inequality decomposition estimates not only overcomes the problems of measuring socio-economic inequality based on self-reported morbidities, but also increases the validity of such measures.