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At least 19 recordsLinked to original sources
PubMedDate not supplied

The effects of breastfeeding and birth spacing on infant and early childhood mortality in Ethiopia.

Research conducted in developing countries clearly demonstrates the positive effects of breastfeeding and widely spaced births on infant survival. The evidence is less clear as to whether these beneficial effects extend into early childhood, and under what conditions. In this paper we examine the effects of breastfeeding and birth spacing on neonatal, post-neonatal, and early childhood mortality in Ethiopia using data from the 1990 National Family and Fertility Survey. Our results provide clear evidence that the increased mortality risks associated with closely-spaced births continue beyond the first year of life into early childhood. Competition between siblings for food and maternal attention is the most probable explanation for this finding. We also find that breastfeeding beyond the second year of life is associated with higher mortality. Given that delayed weaning in Ethiopia is a common response to food shortages, we interpret this finding as further evidence of the negative consequences of resource deprivation for child survival.

Adolescent↗
PubMedDate not supplied

Use of contraceptives for birth spacing in a Nigerian city.

This paper examines the use of contraceptives among women aged 15-35 in the urban area of Ilorin, Nigeria, with particular focus on use for the purpose of spacing births. Approximately 19 percent of ever-married women in the sample had used contraceptives at some time and approximately 6 percent were using at the time of the survey. Results suggest that some women have used or are using contraceptives as a substitute for prolonged periods of postpartum sexual abstinence. Whereas all groups of women in the study prefer to maintain an interval of two years between births, less traditional women no longer prefer to observe long periods of postpartum sexual abstinence. For some women, therefore, there is a wide gap between the length of preferred birth interval and the length of preferred abstinence. The magnitude of this gap is significantly associated with both ever use and current use of contraceptives. Other variables found to have a significant independent effect on contraceptive use were total number of children desired, maternal age, and maternal education.

Adolescent↗
PubMed2002

Birth spacing. Three to five saves lives.

Couples who space their births 3 to 5 years apart increase their children's chances of survival, and mothers are more likely to survive, too, according to new research. Many women want to space births longer than they currently do. Programs can do more to help them achieve the birth intervals they want.

Birth Intervals↗
PubMed1992

Study of the effect of birth spacing on maternal health.

This study aims at identifying the effect of birth spacing on maternal health. The study was carried out on a representative sample of 324 married women at the fertile age period and having at least two children. The result of this study revealed that women practicing birth spacing were 33.3% of the studied sample. The mean age was 34.4 +/- 5.3 years and 31.3 +/- 5.7 years for improper and proper birth spacing respectively. Improper birth spacing women constituted 70.2% of low social class. Out of the total number of improper birth spaced women, 41.7% were overweight, 25.9% were hypertensive, 57.4% had varicose veins, and 18.1% had low limb oedema. Concerning Gynecological findings; vaginal discharge and cervical erosion were 70.4% and 19.4% of improper birth spacing women respectively, laboratory investigations revealed that anaemia and glucosuria were 88.4% and 12.5% of improper birth spacing women respectively. Good knowledge and favorable attitude were 88% and 100% of properly birth spaced women. The mean number of gravidity, number of abortions and number of infant deaths were 6.6 +/- 2.8; 0.9 +/- 1.3 and 1.36 +/- 1.63 of improperly birth spaced women respectively and 4.2 +/- 1.7; 0.6 +/- 1.1 and 0.41 +/- 0.81 of properly birth spaced women respectively. It could be concluded that young women were practicing birth spacing more properly. Rural origin women are less practicing birth spacing. Medical and Gynecological disorders were more among improper birth spacing women. Pregnancy wastage are more among improper birth spacing. It is to be recommended that more efforts should be done among low social class. Encouraging young women to practice pre-natal care. Emphasizing on the practice of proper birth spacing and small family size.

Adult↗
PubMed2004

Effect of prolonged birth spacing on maternal and perinatal outcome.

BACKGROUND: Researchers have held varied opinions on the effect of prolonged birth spacing on maternal and perinatal outcome. OBJECTIVES: To determine the reasons for prolonged birth spacing and to compare the maternal and perinatal outcome compared to shorter normal birth spacing. DESIGN: Comparative case - controlled study between January 1st, 2001 to December 31st, 2002. SETTING: Obstetric Unit of Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria. SUBJECTS: Fifty cases consisted of multiparae with prolonged birth spacing (> or =6 years) and controls consists of similar number of multiparae with shorter normal birth spacing (2 - 5 years) matched for age, parity and socio-economic status. MAIN OUTCOME MEASURES: Labour outcome, Apgar scores, operative and vaginal delivery rates, perinatal and maternal outcome, reasons for prolonged birth spacing. RESULTS: There was no significant difference observed with respect to spontaneous onset of labour, induction or argumentation of labour, duration of labour, spontaneous vaginal delivery rates, Caesarean section rates, instrumental vaginal deliveries, analgesic requirement, postpartum haemorrhage, and Apgar scores in both groups. There were no perinatal or maternal deaths. The commonest reason adduced for prolonged birth spacing is failed contraception (56%), followed by secondary infertility (24%) and to a lesser extent re-marriage, improved income and sheer desire. CONCLUSION: There was no significant difference in maternal and perinatal outcome in pregnancy between women with prolonged birth spacing and those with normal shorter birth spacing.

Adult↗
PubMed1989

Birth-spacing in rural Yangoru, 1970-1987.

Reductions in birth-spacing can have detrimental effects on the mother, on her children and on population growth. Unfortunately, a lack of accurate birth date data in Papua New Guinea makes it difficult to obtain precise information on birth-spacing and its change. This paper reports an attempt to use data derived from Department of Health Baby Books to gauge birth-spacing and its changes over the period 1970-1987 among the Yangoru Boiken of the East Sepik Province. Although Yangoru Boiken society has changed considerably since World War II, the results reveal no significant change in birth spacing over this period.

Birth Intervals↗
PubMed1996

Birth spacing and child survival in rural Senegal.

BACKGROUND: Studies examining the associations between short birth spacing and child mortality have often concentrated on the strength of the associations whilst the public health importance of short spacing in specific communities has received less attention. This study re-examines the association between short birth intervals and child mortality in rural Senegal and discusses the potential direct effects of efforts to delay births on child mortality in this community. METHODS: The study uses longitudinal data in a cohort of 4852 children born between 1983 and 1989. The associations between birth spacing and child mortality are examined using logistic and Cox proportional hazards regression models. RESULTS: The probability of dying before age five is 224 per 1000 livebirths. The median interval between births is 33 months and only 12% of the birth intervals are less than 24 months in length. The odds of dying in the neonatal and post-neonatal period is 2.27 and 2.12 times higher respectively for children born after preceding birth intervals of one year or less compared to children born after longer intervals. Children born within two years of a subsequent birth are at 4.09 times higher risk of dying in the second year of life than children whose mother gave birth more than 2 years after the index birth. CONCLUSIONS: In this community where prolonged breastfeeding causes women to space their births at long intervals, short birth intervals are a consequence rather than a cause of child mortality and the potential direct effects of birth spacing efforts on child mortality are limited. To reduce the high levels of child mortality, efforts will have to be made to ensure effective preventive and curative health services, and to maintain the traditional pattern of breastfeeding.

Birth Intervals↗
PubMed2005

New evidence on birth spacing: promising findings for improving newborn, infant, child, and maternal health.

This editorial summarizes new evidence, some of which is published in this supplement, on birth spacing and newborn, infant, child and maternal health, as well as the demand for birth spacing services in the developing world. The article points to the high number of annual infant, child and maternal deaths, low birth weight infants and malnourished infants and children in developing countries. It highlights several new findings on birth spacing relevant to these conditions: It argues that, in light of the new evidence, birth spacing is an important, feasible and practical intervention to address these conditions and should be included in developing country health programs.

Attitude to Health↗
PubMed1985

Birth spacing and fertility limitation: a behavioral analysis of a nineteenth century frontier population.

Our analysis of changing birth interval distributions over the course of a fertility transition from natural to controlled fertility has examined three closely related propositions. First, within both natural fertility populations (identified at the aggregate level) and cohorts following the onset of fertility limitation, we hypothesized that substantial groups of women with long birth intervals across the individually specified childbearing careers could be identified. That is, even during periods when fertility behavior at the aggregate level is consistent with a natural fertility regime, birth intervals at all parities are inversely related to completed family size. Our tabular analysis enables us to conclude that birth spacing patterns are parity dependent; there is stability in CEB-parity specific mean and birth interval variance over the entire transition. Our evidence does not suggest that the early group of women limiting and spacing births was marked by infecundity. Secondly, the transition appears to be associated with an increasingly larger proportion of women shifting to the same spacing schedules associated with smaller families in earlier cohorts. Thirdly, variations in birth spacing by age of marriage indicate that changes in birth intervals over time are at least indirectly associated with age of marriage, indicating an additional compositional effect. The evidence we have presented on spacing behavior does not negate the argument that parity-dependent stopping behavior was a powerful factor in the fertility transition. Our data also provide evidence of attempts to truncate childbearing. Specifically, the smaller the completed family size, the longer the ultimate birth interval; and ultimate birth intervals increase across cohorts controlling CEB and parity. But spacing appears to represent an additional strategy of fertility limitation. Thus, it may be necessary to distinguish spacing and stopping behavior if one wishes to clarify behavioral patterns within a population (Edlefsen, 1981; Friedlander et al., 1980; Rodriguez and Hobcraft, 1980). Because fertility transition theories imply increased attempts to limit family sizes, it is important to examine differential behavior within subgroups achieving different family sizes. It is this level of analysis which we have attempted to achieve in utilizing parity-specific birth intervals controlled by children ever born.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed2005

Existing demand for birth spacing in developing countries: perspectives from household survey data.

OBJECTIVE: To identify the extent of demand for birth spacing, according to age and parity among married women of reproductive age (MWRA) in developing countries. METHODS: Secondary analysis of data from the Demographic and Health Surveys (DHS) using cross-tabulations. Data collected from nationally representative samples of MWRA in selected developing countries between 1990 and 2004. RESULTS: Demand for birth spacing is the most prevalent reason for an interest in family planning among married women aged 15-29 years in the majority of developing countries examined. In the 15-19-year age cohort, the demand for spacing is proportionally the most prevalent reason for a demand for family planning. A demand for spacing even exists among young, zero-parity married women in each country examined. Findings on the demand for spacing among zero-parity married women quantifies the expressed desire of some married women in developing countries to postpone a first birth or the timing of a first pregnancy. CONCLUSION: The substantial demand for birth spacing among young, low- and zero-parity women suggests that family planning programs in developing countries may need to reevaluate how accessible services are for this cohort of potential contraception users. Currently, many service-delivery protocols, counseling practices and service provider training may not fully address the needs of younger, low- or zero-parity clients.

Adolescent↗
PubMed2006

Birth spacing and risk of adverse perinatal outcomes: a meta-analysis.

CONTEXT: Both short and long interpregnancy intervals have been associated with an increased risk of adverse perinatal outcomes. However, whether this possible association is confounded by maternal characteristics or socioeconomic status is uncertain. OBJECTIVE: To examine the association between birth spacing and relative risk of adverse perinatal outcomes. DATA SOURCES: Studies published in any language were retrieved by searching MEDLINE (1966 through January 2006), EMBASE, ECLA, POPLINE, CINAHL, and LILACS, proceedings of meetings on birth spacing, and bibliographies of retrieved articles, and by contact with relevant researchers in the field. STUDY SELECTION: Included studies were cohort, cross-sectional, and case-control studies with results adjusted for at least maternal age and socioeconomic status, reporting risk estimates and 95% confidence intervals (or data to calculate them) of birth spacing and perinatal outcomes. Of 130 articles identified in the search, 67 (52%) were included. DATA EXTRACTION: Information on study design, participant characteristics, measure of birth spacing used, measures of outcome, control for potential confounding factors, and risk estimates was abstracted independently by 2 investigators using a standardized protocol. DATA SYNTHESIS: A random-effects model and meta-regression analyses were used to pool data from individual studies. Compared with interpregnancy intervals of 18 to 23 months, interpregnancy intervals shorter than 6 months were associated with increased risks of preterm birth, low birth weight, and small for gestational age (pooled adjusted odds ratios [95% confidence intervals]: 1.40 [1.24-1.58], 1.61 [1.39-1.86], and 1.26 [1.18-1.33], respectively). Intervals of 6 to 17 months and longer than 59 months were also associated with a significantly greater risk for the 3 adverse perinatal outcomes. CONCLUSIONS: Interpregnancy intervals shorter than 18 months and longer than 59 months are significantly associated with increased risk of adverse perinatal outcomes. These data suggest that spacing pregnancies appropriately could help prevent such adverse perinatal outcomes.

Birth Intervals↗
PubMed1995

Birth spacing and infant and early childhood mortality in a high fertility area of Bangladesh: age-dependent and interactive effects.

To examine the effects of birth spacing on early childhood mortality, 3729 singleton births in 1983-84 were followed for 3 years in rural Bangladesh. Logistic regression analyses were used to assess whether the survival of older siblings modifies the effect of preceding birth intervals and to see if the effects of preceding and succeeding birth intervals are inter-related, controlling for the effects of sex of the child, mother's age and household economic status. With the exception of the neonatal period, birth spacing effects were highly significant. A preceding birth interval of < 15 months was associated with a greater mortality risk in the post-neonatal period for children with an older sibling who survived infancy. However, a short preceding birth interval did not adversely affect post-neonatal mortality if the older sibling died in infancy. Neonatal and post-neonatal deaths were higher if older siblings had died in respective age intervals. A pregnancy interval of < 12 months after childbirth raised the risk of death at ages 1-2 years considerably if the child was born after a short birth interval (< 15 months). The results suggest that the high mortality risks of closely spaced children are due to sibling competition for parental resources.

Age Factors↗
PubMed1992

Birth spacing and child mortality in a Caribbean population.

Ten independent variables were used to predict death before the first birthday for 4411 births that took place from 1878 to 1976 to 978 women of native ancestry on the island of St. Barthélemy. Significant predictors of death include the death of the mother within a year, the birth year, multiple birth, whether the preceding child also died before 1 year of age, and whether the next child was conceived before the index child was 1 year old. Unlike most prior studies, birth-spacing variables were only weakly related to death in the first year. The relative absence of contraceptive techniques to control birth spacing in the study population and the use of vital records rather than survey data distinguish this project from others and may account at least partly for the unusual findings.

Birth Intervals↗
PubMed1991

Birth spacing and infant mortality in Brazil.

The effects of birth spacing on neonatal and post-neonatal mortality in Brazil were found to be very consistent with models based on data from other South American countries. The model for neonatal mortality simplified to three significant variables, whereas the model for post-neonatal mortality included four significant interactions.

Birth Intervals↗