Structural equation modeling on the relationship between maternal characteristics and pregnancy complications: A study based on National Family Health Survey

J Obstet Gynaecol Res. 2021 Feb;47(2):592-605. doi: 10.1111/jog.14566. Epub 2020 Nov 15.

Abstract

Aim: This study aimed to understand the complex relationship between maternal complications and women's characteristics in India.

Methods: The present study builds structural equation modeling (SEM) using the data from the National Family Health Survey round 4 (2015-16) and includes 190, 898 women who had given their last birth during 5 years preceding the survey. Based on eight questions related to maternal complications, the SEM constructed two latent variables - complications during pregnancy (PREGCOMP) and delivery (DELCOMP).

Results: Result shows that prolonged labor was highly prevalent (42%) among women, followed by vaginal bleeding (34%) and swelling in legs, body or face (32%). Women from affluent households (β = -0.02 for each-middle, richer and richest quantile), with higher education (β = -0.02), timing when they received first ANC (β = -0.003) and women who received full ANC (β = -0.01) had a lower risk of PREGCOMP. However, consanguineous marriage (β = 0.01) was positively related to PREGCOMP. Further, women with PREGCOMP (β = 0.20), rural residents (β = 0.02), having exposure to mass media (β = 0.01), and who had facility delivery (β = 0.04) were at high risk of DELCOMP. Women with pregnancy complications are more likely to have delivery complications. [Correction added on 27 November, after first online publication: The statement "who received full antenatal care (ANC) (β = -0.05)" has been removed.] CONCLUSION: Socioeconomic and demographic factors significantly affect both the latent variables. This study concludes that the use of intensive healthcare services reduces health complications. The paper recommends early visits and full ANC checkups to reduce pregnancy complications.

Keywords: antenatal care; delivery care; maternal complication; structural equation modeling.

MeSH terms

  • Cross-Sectional Studies
  • Female
  • Health Surveys
  • Humans
  • India / epidemiology
  • Latent Class Analysis
  • Maternal Health Services*
  • Pregnancy
  • Prenatal Care*
  • Rural Population
  • Socioeconomic Factors