Abstract
To investigate the relationship between pregnancy intendedness and utilization of recommended prenatal care for mothers and
vaccinations for children against six vaccine preventable diseases in rural India using a prospective dataset. To examine
the association between pregnancy intention and neonatal and infant mortality in rural India. The study is based upon a prospective
follow-up survey of a cohort selected from the National Family Health Survey 1998–1999, carried out in 2002–2003 in rural
areas of four Indian states of Bihar, Jharkhand, Maharashtra and Tamil Nadu. Data for 2108 births for which pregnancy intendedness
was assessed prospectively was analyzed using bivariate analysis, logistic regressions and discrete-time survival analysis.
Mothers reporting unwanted births were 2.32 (95 % CI: 1.54–3.48) times as likely as mothers reporting wanted births to receive
inadequate prenatal care. Moreover, unwanted births were 1.38 (95 % CI: 1.01–1.87) times as likely as wanted births to receive
inadequate childhood vaccinations. Likewise, births that were identified as mistimed/unwanted had 83 % higher risk of neonatal
mortality compared to wanted births. The association between pregnancy intendedness and infant mortality was only marginally
significant. This is the first study of its kind which has investigated the relationship between prospectively assessed pregnancy
intendedness and early childhood mortality in rural India. The study provides additional and more conclusive evidence that
unwanted births are disadvantaged in terms of maternal and child health outcomes. Findings argue for enhanced focus on family
planning to reduce the high prevalence of unintended pregnancy in rural India.
vaccinations for children against six vaccine preventable diseases in rural India using a prospective dataset. To examine
the association between pregnancy intention and neonatal and infant mortality in rural India. The study is based upon a prospective
follow-up survey of a cohort selected from the National Family Health Survey 1998–1999, carried out in 2002–2003 in rural
areas of four Indian states of Bihar, Jharkhand, Maharashtra and Tamil Nadu. Data for 2108 births for which pregnancy intendedness
was assessed prospectively was analyzed using bivariate analysis, logistic regressions and discrete-time survival analysis.
Mothers reporting unwanted births were 2.32 (95 % CI: 1.54–3.48) times as likely as mothers reporting wanted births to receive
inadequate prenatal care. Moreover, unwanted births were 1.38 (95 % CI: 1.01–1.87) times as likely as wanted births to receive
inadequate childhood vaccinations. Likewise, births that were identified as mistimed/unwanted had 83 % higher risk of neonatal
mortality compared to wanted births. The association between pregnancy intendedness and infant mortality was only marginally
significant. This is the first study of its kind which has investigated the relationship between prospectively assessed pregnancy
intendedness and early childhood mortality in rural India. The study provides additional and more conclusive evidence that
unwanted births are disadvantaged in terms of maternal and child health outcomes. Findings argue for enhanced focus on family
planning to reduce the high prevalence of unintended pregnancy in rural India.
- Content Type Journal Article
- Pages 1-8
- DOI 10.1007/s10995-012-1023-x
- Authors
- Abhishek Singh, Department of Public Health & Mortality Studies, International Institute for Population Sciences, Mumbai, 400 088 India
- Ashish Singh, Indira Gandhi Institute of Development Research, Mumbai, 400 065 India
- Bidhubhusan Mahapatra, HIV and AIDS Program, Population Council, 142, Golf links, New Delhi, 110003 India
- Journal Maternal and Child Health Journal
- Online ISSN 1573-6628
- Print ISSN 1092-7875