Investigation of the change in obesity prevalence in married women of reproductive age between 1998 and 2018 and its relationship with some demographic, socioeconomic characteristics and women's status (Advanced Analysis of Turkey Demographic and Health Research )

Köse E, Investigation of the Change in Obesity Prevalence in Married Women of Reproductive Age between 1998 and 2018 and its Relationship with Some Demographic, Socioeconomic Characteristics and Women's Status (Advanced Analysis of Turkey Demographic and Health Research Hacettepe University Graduate School of Health Sciences Epidemiology Program, Doctor of Philosophy Thesis, Ankara 2024.This study aimed to identify the factors associated with obesity in women who were married between the ages of 15-49, using data from the Turkey Demographic and Health Survey (TDHS) conducted in 1998, 2003, 2008, 2013, and 2018. The TDHS is a series of studies carried out at five-year intervals, utilizing a multi-stage, stratified, and weighted sample that represents the entire population of Turkey, providing insights into maternal and child health. This research is a secondary analysis of the five TDHSs. The analysis included women who had been married at least once, were not pregnant at the time of the survey or in the six months prior, and had anthropometric measurements available. The women selected for these surveys represented 22.2%, 31.4%, 80.1%, 68.1%, and 61.1% of the total sample in each corresponding year (TDHS 1998-2018). In this study, a women's status index was created using the principal components method of factor analysis. Four models were developed by sequentially adding variables and analyzing them using the Chi-square test and Hierarchical Binary Logistic Regression. The fifth model was created with statistically significant variables, and the sixth model was created by considering the literature.. The prevalence of obesity among these women across the TDHS 1998-2018 were 19.1%, 23.4%, 35.4%, 35.5%, and 40.1%, respectively. In the sixth model of TDHS 2008, 2013 and 2018, age, education, household welfare level, total number of pregnancies, region in TDHS 2008 and 2013, smoking, age at first marriage, age of spouse; In TDHS 2008 and 2018, sports status, age at first birth; In TDHS 2013 and 2018, education of spouse; In 2018, being employed was also found to be associated with obesity. When analyzing the combined data from TDHS 2008, 2013, and 2018, a statistically significant increasing trend in obesity was observed (p<0.001). The models indicated that age, education level, region, place of residence, employment status, year of survey, household welfare level, sports activity, smoking status, age at first marriage, age at first birth, total number of pregnancies, spouse's age, spouse's education, and spouse's employment status were all significantly associated with obesity. On the other hand, the variables of women's status and father's literacy status included in the model were not found to be significant in the model. The prominent results among the variables associated with obesity in women were having a moderate household welfare level (OR: 1.49 95% CI: 1.29-1.71), women not being employed (OR: 1.09 95% CI: 1.01-1.19), being under 18 at first marriage (OR: 1.25, 95% CI: 1.12-1.39), being under 18 at first birth (OR: 1.18 95% CI 1.03-1.34) and having four or more pregnancies (OR: 1.75 95% CI: 1.49-2.05). In conclusion, the prevalence of obesity among women who had been married at least once during their reproductive years has been rising, though the factors contributing to obesity have shifted over time.