See the published version of this preprint at BMC Pregnancy and Childbirth.
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Background
Three-quarters of pregnancy terminations in Africa are carried out in unsafe conditions. Unsafe abortion is the leading cause of maternal mortality among young women in Sub-Saharan Africa. Greater understanding of the wider determinants of pregnancy termination in this age group could inform the design and development of interventions to mitigate the harm. Previous research has described the trends in and factors associated with termination of pregnancy for women of reproductive age in Nigeria. However, the wider determinants of pregnancy termination have not been ascertained, and data for all women have been aggregated which may obscure differences by age groups. Therefore, we examined the trends in and individual and contextual-level predictors of pregnancy termination among young women aged 15–24 years in Nigeria.
Methods
We analysed data from the 2003, 2008, 2013 and 2018 Nigerian Demographic and Health Surveys (NDHS) comprising 45,793 women aged 15–24 years. Trends in pregnancy termination across the four survey datasets were examined using bivariate analysis. Individual and contextual predictors of pregnancy termination were analysed using a three-level binary logistic regression analysis.
Results
Trends in pregnancy termination declined from 5.8% in 2003 to 4.2% in 2013 then reversed to 4.9% in 2018. The declining trend was greater for women with higher socioeconomic status. Around 17% of the total variation in pregnancy termination was attributable to community factors, and 7% to state-level factors. Of all contextual variables considered, only contraceptive prevalence (proxy for RH service access by young women) at community level was significant. Living in communities with higher contraceptive prevalence increased odds of termination compared with communities with lower contraceptive prevalence (aOR = 4.2; 95% CI 2.7–6.6). At the individual-level, sexual activity before age 15 increased odds of termination (aOR = 2.3; 95% CI 1.9–2.8) compared with women who initiated sexual activity at age 18 years or older, and married women had increased odds compared with never married women (aOR = 3.0; 95% CI 2.5–3.7).
Conclusion
Our findings highlight the importance of disaggregating data for women across the reproductive lifecourse, and indicates where tailored interventions could be targeted to address factors associated with pregnancy termination among young women in Nigeria.
Keywords
Maternal health, adolescence, health inequalities, sustainable development goals, prevalence, low middle income countries
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CURRENT STATUS: Published
View the published article at BMC Pregnancy and Childbirth.
No community comments so far
Submission checks complete
On 10 Aug, 2020
Editorial decision: Accept
On 10 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 04 Aug, 2020
Editor assigned
On 29 Jul, 2020
Submission checks complete
On 28 Jul, 2020
Editor invited
On 28 Jul, 2020
Version 1
Posted 08 Jun, 2020
No comments provided
Review #2 received
Received 27 Jun, 2020
Editorial decision: Major revision
On 27 Jun, 2020
Review #3 received
Received 27 Jun, 2020
Review #1 received
Received 22 Jun, 2020
Reviewer #3 agreed
On 18 Jun, 2020
Reviewer #4 agreed
On 18 Jun, 2020
Reviewer #2 agreed
On 15 Jun, 2020
Reviewer #1 agreed
On 10 Jun, 2020
Reviewers invited
Invitations sent on 10 Jun, 2020
Editor assigned
On 01 Jun, 2020
Submission checks complete
On 31 May, 2020
Editor invited
On 31 May, 2020
First submitted
On 18 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
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A new preprint design is coming!
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See the published version of this preprint at BMC Pregnancy and Childbirth.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Pregnancy and Childbirth.
No community comments so far
Submission checks complete
On 10 Aug, 2020
Editorial decision: Accept
On 10 Aug, 2020
No comments provided
Editorial decision: Minor revision
On 04 Aug, 2020
Editor assigned
On 29 Jul, 2020
Submission checks complete
On 28 Jul, 2020
Editor invited
On 28 Jul, 2020
Version 1
Posted 08 Jun, 2020
No comments provided
Review #2 received
Received 27 Jun, 2020
Editorial decision: Major revision
On 27 Jun, 2020
Review #3 received
Received 27 Jun, 2020
Review #1 received
Received 22 Jun, 2020
Reviewer #3 agreed
On 18 Jun, 2020
Reviewer #4 agreed
On 18 Jun, 2020
Reviewer #2 agreed
On 15 Jun, 2020
Reviewer #1 agreed
On 10 Jun, 2020
Reviewers invited
Invitations sent on 10 Jun, 2020
Editor assigned
On 01 Jun, 2020
Submission checks complete
On 31 May, 2020
Editor invited
On 31 May, 2020
First submitted
On 18 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Pregnancy and Childbirth.
Background
Three-quarters of pregnancy terminations in Africa are carried out in unsafe conditions. Unsafe abortion is the leading cause of maternal mortality among young women in Sub-Saharan Africa. Greater understanding of the wider determinants of pregnancy termination in this age group could inform the design and development of interventions to mitigate the harm. Previous research has described the trends in and factors associated with termination of pregnancy for women of reproductive age in Nigeria. However, the wider determinants of pregnancy termination have not been ascertained, and data for all women have been aggregated which may obscure differences by age groups. Therefore, we examined the trends in and individual and contextual-level predictors of pregnancy termination among young women aged 15–24 years in Nigeria.
Methods
We analysed data from the 2003, 2008, 2013 and 2018 Nigerian Demographic and Health Surveys (NDHS) comprising 45,793 women aged 15–24 years. Trends in pregnancy termination across the four survey datasets were examined using bivariate analysis. Individual and contextual predictors of pregnancy termination were analysed using a three-level binary logistic regression analysis.
Results
Trends in pregnancy termination declined from 5.8% in 2003 to 4.2% in 2013 then reversed to 4.9% in 2018. The declining trend was greater for women with higher socioeconomic status. Around 17% of the total variation in pregnancy termination was attributable to community factors, and 7% to state-level factors. Of all contextual variables considered, only contraceptive prevalence (proxy for RH service access by young women) at community level was significant. Living in communities with higher contraceptive prevalence increased odds of termination compared with communities with lower contraceptive prevalence (aOR = 4.2; 95% CI 2.7–6.6). At the individual-level, sexual activity before age 15 increased odds of termination (aOR = 2.3; 95% CI 1.9–2.8) compared with women who initiated sexual activity at age 18 years or older, and married women had increased odds compared with never married women (aOR = 3.0; 95% CI 2.5–3.7).
Conclusion
Our findings highlight the importance of disaggregating data for women across the reproductive lifecourse, and indicates where tailored interventions could be targeted to address factors associated with pregnancy termination among young women in Nigeria.
Figure 1
Figure 2
This is a list of supplementary files associated with this preprint. Click to download.
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