Some models of unintended pregnancy through matched case-control design in India
by
Sada Nand Dwivedi
Department of Biostatistics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India
Coauthors: Shahina Begum, Department of Biostatistics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110029, India

Introduction: Unplanned pregnancy (i.e., unwanted and mistimed) is an important reproductive health concern because it may be associated with various health problems. Further, under case-control analysis, matching is preferred to derive more precise results.

Objective: To find out the determinants of unwanted and mistimed pregnancy through matched case-control design in India.

Methods: Data were drawn from the National Family Health Survey (NFHS-II, 1998-99). Study is based on the pregnancies among a sample of women at country level who were still pregnant at the time of interview. At the time of interview, a pregnancy that was not wanted at all was defined as unwanted pregnancy and that was wanted later as mistimed. To carry out case-control analysis of both, matched controls in the ratio of 1:1 were considered that were randomly matched using parity as matching variable within states from the pregnancies that were reported as wanted. Conditional logistic regression analysis was used to workout the models and find out the factors associated with unwanted and mistimed pregnancy. Effort was made to take into account various steps of epidemiological modeling.

Results: Women who were educated middle school and above, belong to high standard of living index, had at least one surviving son, and ever-contraceptive users had more chance to have unwanted pregnancy. Those who were educated above middle school, non-Hindu, living in extended family, had at least one surviving son, pregnant at shorter interval, exposed to mass-media, depend on decisions made by others in the family about obtaining healthcare for self had more chance to have mistimed pregnancy.

Conclusion: There is still need to have educative and public health programs on the need of contraceptive adoption by at least those who have at least one leaving son. Women who are from extended family and rely on decision by other family members should be encouraged to adopt spacing methods.

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Date received: October 10, 2005