High-Risk Fertility Behavior and Its Associated Factors Among Women in Wad Madani Maternity Hospital, Sudan: A Cross-Sectional Study

Background: The literature indicates that high-risk fertility behavior (HRFB) is prevalent in resource-limited settings. However, there is currently no data available on this issue in Sudan. This study aimed to investigate the prevalence and factors associated with HRFB among Sudanese women at Wad Madani Maternity Hospital in Gezira State, Sudan. Methods: A hospital-based cross-sectional study was conducted between 1 September and 1 December 2023. A total of 380 pregnant women who gave birth at Wad Madani Maternity Hospital were enrolled. The women’s sociodemographic characteristics and obstetrical data were assessed using a face-to-face questionnaire. The primary outcome was HRFB. Primary associated factors included maternal body mass index (BMI) and education level, while secondary outcomes focused on the distribution of individual risk categories. Multivariable binary regression analysis was performed. Results: The median (interquartile range [IQR]) age and parity of the enrolled women were 26.5 (23.0–30.0) years and 2 (1–4), respectively. Of 380 women, 171 (45.0%, 95% confidence interval [CI] = 39.9–50.0%) had HRFB and 209 (55.0%, 95% CI = 49.9–60.1%) had no HRFB. Fifty-four (14.2%, 95% CI = 10.7–17.7%) women were classified as having multiple HRFBs, defined as the presence of two or more risk factors, and 117 (30.8%, 95% CI = 26.3–35.6%) had a single HRFB. In the multivariable binary regression analysis, high BMI (adjusted odds ratio [AOR] = 1.08, 95% CI, 1.03–1.13) and low maternal education level (AOR = 2.21, 95% CI, 1.45–3.37) were associated with having an HRFB. No significant associations were found between maternal employment and HRFB. Conclusions: The study revealed a high prevalence of HRFB (45.0%) among women in Wad Madani Maternity Hospital, Sudan, which was associated with low maternal education levels and BMI. Addressing these factors is needed to improve maternal and perinatal health outcomes in this hospital.