Determinants of advanced age pregnancy in Ethiopian; multi-level analysis of Ethiopian demographic health survey 2016

Background: Advanced maternal-age pregnancy has become a serious public health problem in both developed and developing countries due to adverse birth outcomes for the mother, fetus, or newborn. However, there are limited studies conducted to identify determinants of advanced-age pregnancy in Ethiopia. Therefore, this study aimed to assess individual and community-level determinants of advanced age pregnancy in Ethiopia. Methods: This study was based on 2016 Ethiopian Demographic and Health Survey data. Three thousand two hundred ninety-two weighted samples of pregnant women were included in this analysis. A multilevel logistic regression model was conducted to assess the determinants of advanced-age pregnancy among the study participants in Ethiopia. Results: maternal age at first birth (AOR = 4.05, 95% CI: 1.77–9.22), level of maternal education [primary education 2.72 times (AOR = 2.27, 95 CI: 1.55–4.76) and secondary and above education (AOR = 5.65, 95% CI: 1.77–17.70)], having a history of alcohol (AOR = 11.8, 95% CI: 5.71–24.42), parity (AOR = 3.22, 95% CI: 2.69–3.84), number of household member (AOR = 1.22, 95% CI: 1.05–1.41), family planning unmet need for spacing of pregnancy (AOR = 4.79, 95% CI: 2.63–8.74), having sons/daughters elsewhere (AOR = 1.89, 95% CI: 1.22–2.94), had higher community poverty level (AOR = 2.37, 95% CI: 1.16–4.85), those had higher community unmet need for family planning (AOR = 5.19, 95% CI: 2.72–9.92) were more likely to have advanced age pregnancy. Whereas Living in an Emerging region (AOR = 0.29, 95% CI: 0.14–0.59) and living in a metropolitan city (AOR = 0.03, 95% CI: 0.03–0.38), were less likely to have advanced age pregnancy. Conclusions: increased Maternal age at first birth, level of maternal education, history of alcohol drinking, increased number of parity and household members, family planning unmet need for spacing, had sons/daughters elsewhere, had higher community poverty level, those had higher community unmet need for family planning positively, whereas living in the emerging region and living in metropolitan’s city was negatively affect advanced age pregnancy. Help women to have informed decision-making and create platforms to women have special care during this age of pregnancy. Empower women on family planning and socioeconomic status.