Maternal age, gravidity, and pregnancy spacing effects on spontaneous fetal mortality

Soc Biol. 1989 Fall-Winter;36(3-4):186-212. doi: 10.1080/19485565.1989.9988731.

Abstract

Differentials in the probability of pregnancy loss are examined using pregnancy history data from eight WFS surveys in developing countries. Multiple logistic regression equations are estimated. The probability of loss varies substantially over the reproductive career. Both higher-order pregnancies and those conceived at older ages are more likely to terminate in loss. maternal age differentials are more pronounced for lower-order pregnancies. First and second pregnancies conceived over age thirty suffer especially high levels of loss. Pregnancies conceived relatively soon after the termination of the previous pregnancy are more likely to be lost, as are pregnancies conceived after long intervals. Risk of loss is higher for women previously experiencing loss, and the effect persists beyond the pregnancy following the loss.

PIP: Differentials in the probability of pregnancy loss are examined using pregnancy history data from 8 World Fertility Surveys (WFS) in developing countries. For this analysis we select 8 countries where the coverage appears relatively complete: Ivory Coast, Tunisia, Syria, Korea, the Philippines, Costa Rica, Mexico, and Guyana. Multiple logistic regression equations are estimated. The probability of loss varies substantially over the reproductive career. Both higher-order pregnancies and those conceived at older ages are more likely to terminate in loss. Maternal age differentials are more pronounced for lower-order pregnancies. 1st and 2nd pregnancies conceived over age 30 suffer especially high levels of loss. Pregnancies conceived relatively soon after the termination of the previous pregnancy are more likely to be lost, as are pregnancies conceived after long intervals. Risk of loss is higher for women previously experiencing loss, and the effect persists beyond the pregnancy following the loss. The differentials by maternal education are rather small in the Ivory Coast, Tunisia, the Philippines, and Costa Rica. In Syria, Korea, and Mexico, better- educated women report a higher percentage loss, where in Guyana an inverse pattern emerges. The majority of the Guyanese sample, however, falls into the highest educational category. Excepting Syria, Korea, and Mexico, there is no evidence of markedly better reporting, or of higher proportions of disguised induced losses, among the better educated. Differentials by type of place of residence are somewhat sharper and more uniform, with rural women in all 8 countries reporting the lowest rates of loss. As completeness of reporting would seem more likely to be associated with maternal education than place of residence, we interpret the latter differentials as reflective of a higher incidence of induced loss (reported as spontaneous) in urban areas, where abortion services are likely to be more available.

MeSH terms

  • Adolescent
  • Adult
  • Birth Intervals*
  • Birth Order
  • Developing Countries
  • Educational Status
  • Female
  • Fetal Death*
  • Humans
  • Maternal Age*
  • Parity*
  • Pregnancy
  • Residence Characteristics