Spatial evaluation of pregnancy loss among child-bearing women in India

The present study identifies the prevalence, pattern & geographical distribution of pregnancy loss and its various determinants. The choropleth equal interval maps and local indicators of spatial association maps were used to investigate the locations requiring attention. Spatial regression techniques were used to investigate the factors associated with pregnancy losses across India using data derived from the fourth round of National Family Health Survey. A decision tree was constructed to investigate the interaction effect of the significant factors.The percentage of pregnancy loss in India is noted to be 14.3% (95% BCa confidence interval: 13.47, 14.79). The spatial autocorrelation coefficient (ρ=0.61,p<0.001\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\rho = 0.61,~p < 0.001$$\end{document}) indicated the spatial dependence in the data. Hotspots of response variable were observed in districts of Uttar Pradesh, Manipur, and Odisha. Locations, with high percentage of women who have attained education upto high school and above, women who did not want the pregnancy, and women whose family did not want more child, were likely to have increased percentage of pregnancy loss. Struggles in a womens life, family’s pressure and own desire to have child coupled with their education status are related to the pregnancy loss. Preventing the unplanned pregnancies will play a pivotal role in decreasing the pregnancy loss which further prevents maternal mortality and morbidity. Timely and adequate supplies of contraception in public health institutions particulary sub-centre, primary health centre should be ensured.