State reports highest pregnancy wastage in country
Source: Chronicle News Service / Keicha Chingthou Mangang

Imphal, February 01 2025: A recent study published in The Journal of Obstetrics and Gynaecology of India has revealed alarming trends in pregnancy wastage in Manipur.

Despite a gradual decline in hotspot clusters, the state continues to report the highest prevalence of pregnancy wastage in India, such as abortion, miscarriage, and stillbirth.

The research, based on data from the National Family Health Surveys (NFHS-4, 2015-2016, and NFHS-5, 2019-2021), aims to assess spatial clustering and identify socio-demographic and health-related determinants of pregnancy wastage across nine districts in the state.

The study was conducted by an eight-member multidisciplinary team of researchers.

The team included Meena Hijam, Nandeibam Alfred Rozer, and Arun Naorem, who serve as project technical officers in the department of community medicine at Jawaharlal Nehru Institute of Medical Sciences, Imphal.

Khangembam Jitenkumar Singh, who works as scientist E at the 1CMR, New Delhi, also contributed to the study, alongside Sharatchan dra Haobijam, a faculty member in the department of statistics at Manipur University, and Nongzaimayum Tawfeeq Alee, an assistant professor in the department of applied psychology at Gandhi Institute of Technology and Management (GITAM), Visakhapatnam.

Haobijam Nirendrakumar Singh, an associate professor in the department of community medicine at JNIMS, Imphal, and Pouningai Gonmei, an intern at ICMR-National Institute of Medical Statistics, New Delhi, were also part of the research team.

The study used the Getis-Ord Gi spatial statistical tool to identify high-risk clusters and Bayesian logistic regression to analyse factors influencing pregnancy outcomes.

Researchers noted that the valley districts of Imphal East, Imphal West, Thoubal, and Bishnupur exhibited persistent hotspot clusters, while the hill districts showed no significant clustering.

From NFHS-4 to NFHS-5, these clusters decreased significantly, yet Manipur still recorded a pregnancy wastage rate of 15 per cent against the national average of 8.8 per cent.

The analysis highlighted a decline in live births from 85.8 per cent in NFHS-2 to 76.8 per cent in NFHS-5, while non-live births rose from 14.2 per cent to 23.2 per cent.

Miscarriages increased from 6.6 per cent to 12.3 per cent over the same period, while abortion rates remained stable at around 10 per cent.

The prevalence of pregnancy wastage was most pronounced in the valley regions, suggesting the influence of urbanisation, lifestyle changes, and better reporting mechanisms.

The study identified several socio-demographic determinants contributing to pregnancy wastage.

Women with higher education levels were found to be 37 per cent less likely to experience abortion, and working women were 36 per cent less likely to face the same outcome, suggesting the protective role of awareness and financial stability.

However, middle-aged mothers (25-34 years) were 1.5 times more likely to experience abortion compared to younger women.

Overweight and obese women faced a 52 per cent higher likelihood of abortion and a 48 per cent greater risk of miscarriage compared to those with normal body mass index (BMI), highlighting the critical role of healthy lifestyles.

Antenatal care (ANC) practices also influenced pregnancy outcomes.

Women who attended ANC more than four times were twice as likely to experience abortion but had a 9 per cent lower risk of miscarriage.

Smokeless tobacco use was linked to a 49 per cent higher probability of abortion, further emphasising the need for targeted behavioural interventions.

Socio-economic status played a significant role, with women from wealthier families exhibiting an 88 per cent higher risk of abortion compared to those from poorer households.

Religious and cultural factors also emerged as significant influences.

Christian women reported a 33 per cent lower likelihood of miscarriage compared to Hindu women, suggesting a potential protective role linked to lifestyle or community practices.

Scheduled Tribe (ST) women were found to have lower rates of abortion and miscarriage than those from Other Backward Classes (OBC) and Scheduled Caste (SC) groups.

The study also highlighted the stark regional disparities within the state.

While the valley districts showed persistent clusters of pregnancy wastage, the hill districts reflected lower reporting, potentially due to limited healthcare access and cultural factors.

Researchers stressed the need for district-specific interventions to address these variations effectively.

The findings call for immediate policy action to tackle pregnancy wastage in the state.

Enhancing antenatal care services, promoting education and awareness campaigns on healthy lifestyles, and addressing socio-economic disparities are critical steps.

The study also recommended reducing the stigma associated with abortion and miscarriage through community-based psycho-education programmes.

Improved health infrastructure, coupled with holistic counselling services for pregnant women, was emphasised as a priority.

Despite the decline in hotspot clusters over the years, the high prevalence of pregnancy wastage in the state underscores the urgent need for targeted policies and interventions.

The researchers concluded that addressing the socio-cultural, economic, and health determinants of pregnancy outcomes would not only improve maternal health but also contribute to broader public health goals in the state.

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