4.3.2 Educational attainment, cognitive performance and medical abortion
Previous observational studies yielded inconsistent results on the association between educational attainment and medical abortion[19, 23, 24]. Women with primary and secondary education had higher odds of terminating their pregnancies compared to women with no education, but the odds of terminating their pregnancies were not higher among women with tertiary education[24], suggesting that there may not be a linear causal relationship between education and termination of pregnancies[19, 24].
However, education was observed to reduce the risk of medical abortion in present study in UVMR analysis using the IVW method, complementary methods and in MVMR analysis. The causal relationship between education and induced abortion may be influenced by the economic level of the region, as the frequency of abortion was high among less educated women in the developed region of Norway, however, the frequency of abortion was conversely high among university educated women in the less developed region of Pakistan[25]. We found that EA was still associated with decreased risk of MA, after moderating for HI. Educational attainment is a proxy for intelligence, and cognitive ability is often measured through intelligence as well as educational attainment. Research published by Woodley Menie MA confirmed that there was no significant linear or quadratic relationship between the number of abortions and maternal cognitive ability (as measured by educational attainment or general intelligence)[26].