Abstract
A large body of research has shown that children born after especially short or long birth intervals experience an elevated risk of poor perinatal outcomes, but recent work suggests this may be explained by confounding by unobserved family characteristics. We use Swedish population data on cohorts born 1981–2010 and sibling fixed effects to examine whether the length of the birth interval preceding the index child influences the risk of preterm birth, low birth weight, and hospitalization during childhood. We also present analyses stratified by salient social characteristics, such as maternal educational level and maternal country of birth. We find few effects of birth intervals on our outcomes, except for very short intervals (less than seven months) and very long intervals (>60 months). We find few differences in the patterns by maternal educational level or maternal country of origin after stratifying by the mother’s highest educational attainment.
Highlights
A large body of work has examined how the length of intervals between births is related to birth outcomes and the health of the child
For hospitalizations at ages 1–3, the incidence is highest among children born after the shortest interpregnancy intervals (IPIs), but is not elevated for children born after the longest IPIs of more than five years
In this study we have examined the effects of IPI length on the probability of poor perinatal outcomes and the risk of hospitalization during childhood, as Probability of hospitalization at ages 7−10
Summary
A large body of work has examined how the length of intervals between births is related to birth outcomes and the health of the child. This literature has consistently shown that interpregnancy intervals (IPIs) that are short (e.g. less than 18 months) or long (e.g. 60+ months) increase the risk of a range of poor outcomes (Conde-Agudelo et al 2006). A series of studies have attempted to control for the shared family environment by comparing siblings born to the same mother. Several studies in high-income countries have found that after adopting this approach, the association between short or long birth intervals and poor perinatal outcomes is completely removed (Ball et al 2014; Class et al 2017; Hanley et al 2017). Potential differences across social groups have been ignored in the most recent body of literature that has attempted to control for unobserved shared frailty in the sibling group
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