High fertility does not cause spontaneous intrauterine fetal loss: the determinants of spontaneous fetal loss in Egypt

This study is concerned with a major, though relatively neglected, reproductive health issue: fetal loss. In particular, the determinants of spontaneous intrauterine mortality in Egypt are investigated with stress on the demographic determinants. To this end, a conceptual framework is developed. Using pregnancy history data from a national survey conducted in Egypt in 1995, the determinants of spontaneous intrauterine fetal deaths among currently married women aged 18-45 are examined using multiple logistic models. It is found that the probability of intrauterine fetal loss rises with maternal age. The apparent positive association of the risk with gravidity is shown to be an artifact, due to the heterogeneity among women with respect to the risk of pregnancy loss, the consequent selection process, and reproductive compensation behavior according to the "success/failure" stopping rule. Therefore, high fertility cannot be said to cause spontaneous fetal loss. Two other features of a woman's reproduction are of strong significance, namely, her pregnancy history and spacing among pregnancies. Once a woman suffers from spontaneous fetal loss, the probability of undergoing further pregnancy losses rises sharply. And the shorter the pregnancy interval, the higher the probability of pregnancy loss. Pregnancies conceived after long intervals are less likely to end in loss.