Association between high-risk fertility behaviours and the likelihood of chronic undernutrition and anaemia among married Bangladeshi women of reproductive age

Public Health Nutr. 2017 Feb;20(2):305-314. doi: 10.1017/S136898001600224X. Epub 2016 Sep 9.

Abstract

Objective: To explore the association between high-risk fertility behaviours and the likelihood of chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition among women of reproductive age.

Design: The 2011 Bangladesh Demographic and Health Survey, conducted from 8 July to 27 December 2011.

Setting: Selected urban and rural areas of Bangladesh.

Subjects: A total of 2197 ever-married women living with at least one child younger than 5 years. Exposure was determined from maternal reports of high-risk fertility behaviours. We considered three parameters, maternal age at the time of delivery, birth order and birth interval, to define the high-risk fertility behaviours. Chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition among women were the outcome variables.

Results: A substantial percentage of women were exposed to have a high-risk fertility pattern (41·8 %); 33·0 % were at single high-risk and 8·8 % were at multiple high-risk. After adjusting for relevant covariates, high-risk fertility behaviours were associated with increased likelihood of chronic undernutrition (adjusted relative risk; 95 % CI: 1·22; 1·03, 1·44), anaemia (1·12; 1·00, 1·25) and the coexistence of anaemia and undernutrition (1·52; 1·17, 1·98). Furthermore, multiple high-risk fertility behaviours appeared to have more profound consequences on the outcome measured.

Conclusions: Maternal high-risk fertility behaviours are shockingly frequent practices among women in Bangladesh. High-risk fertility behaviours are important predictors of the increased likelihood of women's chronic undernutrition, anaemia and the coexistence of anaemia and undernutrition.

Keywords: Anaemia; Birth interval; Birth order; High-risk fertility behaviours; Mother’s age at birth; Undernutrition.

MeSH terms

  • Adolescent
  • Adult
  • Anemia / etiology
  • Anemia / psychology*
  • Bangladesh
  • Birth Intervals
  • Chronic Disease
  • Female
  • Fertility*
  • Health Surveys
  • Humans
  • Malnutrition / etiology
  • Malnutrition / psychology*
  • Maternal Age
  • Pregnancy
  • Pregnancy Complications / etiology
  • Pregnancy Complications / psychology
  • Risk-Taking*
  • Rural Population
  • Socioeconomic Factors
  • Spouses / psychology*
  • Urban Population
  • Young Adult