Determinants associated with high-risk fertility behaviours among reproductive aged women in Bangladesh: a cross-sectional study

Plain Language Summary High rates of maternal high-risk fertility behaviour (HRFB) have a variety of unfavourable repercussions for both the mother and the child. However, because there have been few studies on this topic to date, we set out to identify the determinants that enhance the risk of HRFB in Bangladeshi women between the ages of 15 and 49. Using latest demographic and health survey (BDHS) data we have found that 67.7% of women had HRFB, with 45.6% having a single high-risk factor and 22.1% having multiple high-risk factors. This high prevalence rate demonstrates that HRFB are all too common in Bangladesh, potentially endangering the health of the country's women. We found that women practicing Islam as core religion, age above 35 years, having normal childbirth, having above 3 children, having unwanted pregnancies and not using birth control methods were at increased risk of having HRFB. As a result of the study's findings, interventions are urgently needed to prevent high-risk fertility behaviour among Bangladeshi women aged 15 to 49 years. Background We aimed to determine the factors that increase the risk of HRFB in Bangladeshi women of reproductive age 15-49 years. Methods The study utilised the latest Bangladesh Demographic and Health Survey (BDHS) 2017-18 dataset. The Pearson's chi-square test was performed to determine the relationships between the outcome and the independent variables, while multivariate logistic regression analysis was used to identify the potential determinants associated with HRFB. Results Overall 67.7% women had HRFB among them 45.6% were at single risk and 22.1% were at multiple high-risks. Women's age (35-49 years: AOR = 6.42 95% CI 3.95-10.42), who were Muslims(AOR = 5.52, 95% CI 2.25-13.52), having normal childbirth (AOR = 1.47, 95% CI 1.22-1.69), having unwanted pregnancy (AOR = 10.79, 95% CI 5.67-18.64) and not using any contraceptive methods (AOR = 1.37, 95% CI 1.24-1.81) were significantly associated with increasing risk of having HRFB. Alternatively, women and their partners' higher education were associated with reducing HRFB. Conclusion A significant proportion of Bangladeshi women had high-risk fertility behaviour which is quite alarming. Therefore, the public health policy makers in Bangladesh should emphasis on this issue and design appropriate interventions to reduce the maternal HRFB.