{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T15:38:46Z","timestamp":1788881926731,"version":"build-2803163510"},"reference-count":51,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Childhood morbidity and mortality are key indicators of human development, particularly reflecting poor health conditions in children. In Pakistan, child mortality remains a serious problem despite efforts to reduce it. One factor that may be associated with child mortality is an undesired pregnancy, whether unwanted (the parents did not want more children) or mistimed (the pregnancy occurred earlier than desired). Unwanted pregnancies and births are psychological factors that negatively impact children\u2019s nutritional health. The main objective of the study is to measure the impact of mothers\u2019 aspired status on child mortality and morbidity in Pakistan. We limited our analysis to children under 5 before the survey and used Pakistan demographic health survey conducted in 2017-2018, a national representative cross-sectional survey. We were able to predict the unwanted state (excess in boys, girls, both, and parity) by subtracting the ideal number of children from total live births. Morbidity (fever, diarrhea, cough, acute respiration infection, and Short rapid breathing), nutritional status, and mortality were also evaluated. We perform machine learning techniques such as random forest (RF) and neural network (NN) in the analysis of the data. The findings revealed that the overall percentage of the undesired child was 8%, 4%, 15%, and 27% for boys, girls, parity, and dual excess, respectively. Finally, we perform multivariate analysis following the principal component analysis (PCA) to study the relationship between variables. All the variables were associated with the unwanted child. Child morbidity, fever, and cough were higher among the undesired children. We found evidence that undesired children have acute respiration infection and that an unwanted child has a significant impact on childhood diseases. The ratio of child mortality was lower for boys but higher for girls.<\/jats:p>","DOI":"10.1371\/journal.pone.0323845","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T17:37:34Z","timestamp":1748626654000},"page":"e0323845","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Undesired nexus poor health status of child under-five: A case study of Pakistan"],"prefix":"10.1371","volume":"20","author":[{"given":"Urva","family":"Zainab","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6018-4011","authenticated-orcid":true,"given":"Mohsin","family":"Abbas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4626-5525","authenticated-orcid":true,"given":"Amena","family":"Urooj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahwish","family":"Rabia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaping","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Ahmed Shehzad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"issue":"2","key":"pone.0323845.ref001","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1177\/0272684X20972840","article-title":"The prevalence and causes of unwanted pregnancy among woldia university undergraduate female students: implications for psychosocial intervention","volume":"42","author":"W Ayalew Tegegne","year":"2022","journal-title":"Commun Health Equity Res Policy"},{"issue":"1","key":"pone.0323845.ref002","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-016-1183-6","article-title":"Perceptions and experiences of using a nipple shield among parents and staff - an ethnographic study in neonatal units","volume":"17","author":"R Flacking","year":"2017","journal-title":"BMC Pregnancy Childbirth"},{"issue":"4","key":"pone.0323845.ref003","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1111\/j.1728-4465.2010.00250.x","article-title":"Unintended pregnancy: worldwide levels, trends, and outcomes","volume":"41","author":"S Singh","year":"2010","journal-title":"Stud Fam Plann"},{"issue":"6","key":"pone.0323845.ref004","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/S0091-2182(98)00063-9","article-title":"Unintended pregnancy. 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Women\u2019s autonomy and unintended pregnancy among reproductive age women in Pakistan. 2023."},{"key":"pone.0323845.ref006","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1007\/s10995-016-2208-5","article-title":"Under-five child mortality and morbidity associated with consanguineous child marriage in Pakistan: retrospective analysis using Pakistan demographic and health surveys, 1990\u20131991, 2006\u20132007, 2012\u20132013","volume":"21","author":"M Mustafa","year":"2017","journal-title":"Matern Child Health J"},{"key":"pone.0323845.ref007","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12905-020-01112-4","article-title":"Demand-and supply-side factors associated with the use of contraceptive methods in Pakistan: a comparative study of demographic and health surveys, 1990\u20132018","volume":"20","author":"S Jabeen","year":"2020","journal-title":"BMC Womens Health"},{"key":"pone.0323845.ref008","article-title":"Health survey 2012\u20132013. 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