Birth Interval Research Articles

Determinants of suboptimal birth spacing among reproductive-age women in Adama district, Ethiopia: a community-based unmatched case-control study

BackgroundBirth spacing is crucial for ensuring the health of mothers and their children, as well as determining population growth. Short birth intervals represent a universal public health problem associated with adverse maternal, fetal, neonatal, and child outcomes. However, there is limited information in the study area regarding the determinants of suboptimal birth spacing. Thus, this study aimed to identify the determinants of suboptimal spacing among women of reproductive age in the Adama district, Ethiopia.MethodsA community-based unmatched case-control study was conducted among 568 randomly selected reproductive-age women using the multi-stage sampling technique. Data were collected using an interviewer-administered, structured questionnaire. The collected data were entered into Epi Info version 7.2 and analyzed using SPSS version 26. Binary logistic regression analysis was used to model the association between suboptimal birth spacing and independent variables. Adjusted odds ratios with their 95% confidence intervals were calculated to determine the strength of the association. A p-value < 0.05 was considered to declare statistical significance.ResultEducational status (no formal education) (AOR = 2.40; 95% CI: 1.23–1.75), inadequate knowledge of optimal birth space (AOR = 2.60; 95% CI; 1.80–3.90), non-use of modern contraceptives (AOR = 3.00; CI: 1.90–4.20), short breastfeeding duration (AOR = 2.30; 95% CI: 1.50–3.40), and having female index child (AOR = 1.60; 95% CI: 1.13–2.50) were independent determinants of suboptimal birth spacing practice.ConclusionEncouraging women’s education, contraceptive use, and breastfeeding is crucial for birth spacing. Community health initiatives should also focus on preventing sex-based birth intervals.

Empowering Maternal Choice: Exploring Factors Influencing Early Postpartum Contraceptive Adoption Intention Among Pregnant Women in Northeast Ethiopia

Background: Despite progress in access to family planning services in many sub-Saharan African countries in recent decades, advances in early postpartum contraceptive adoption remain low, and the unmet need for early postpartum contraceptives is high. According to the Ethiopia Demographic and Health Survey report, early postpartum modern contraceptive method uptake is still unacceptably low in Ethiopia. Objectives: This study aimed to determine the magnitude of intention to adopt early postpartum modern contraceptive methods and its associated factors among pregnant women in Dessie and Kombolcha town zones, northeast Ethiopia. Methods: A community-based cross-sectional study was deployed from 15 January–15 February 2023, in the Dessie and Kombolcha zones, northeast Ethiopia, among pregnant women. The study involved 780 pregnant women using the cluster sampling technique. A census was conducted in 20 randomly selected clusters to identify eligible pregnant women. Actual data were collected home-to-home in the community through face-to-face interviews. Data were collected by Open Data Kit (ODK) and exported to STATA 17 for analysis. A multivariable logistic regression analysis was performed, and the goodness of the model was checked by Hosmer–Lemeshow’s test statistic and rock curve. An adjusted odds ratio with a 95% confidence interval and p-value &lt; 0.05 was considered statistically significant. Result: The study revealed that 49.6% of pregnant women lack autonomy and 50% lack knowledge about early postpartum contraception, with participants’ wealth index status ranging from rich (36.6%) to poor (33.2%). The study found that 75.8% of pregnant women intended to adopt early postpartum modern contraceptive methods early after childbirth. After controlling the potential confounders, mother’s age (AOR = 6.2 [2.6–14.6], birth interval (AOR = 2.5 [1.6–3.7]), have paid work (AOR = 1.9 [1.3–2.8]), health facility from home (AOR = 2.6 [1.5–4.4]), last delivery Place (AOR = 2.4 [1.1–5.7]), knowledge on (AOR = 1.5 [1.1–2.1]), and antenatal care follow-up (AOR = 1.9 [1.2–3.3]) were significant associated factors of intention to uptake early postpartum modern contraceptive methods among pregnant women. Conclusions: The study found that 75% of the participants had the intention to adopt contraceptive methods during the early postpartum period. Identified factors influencing this intention were age, birth interval, women’s employment status, area of residence, distance to health facilities, last delivery place, knowledge of early postpartum modern contraception, gravidity, and antenatal care follow-up. These findings highlight the need for targeted interventions to address these factors, framing the intended users and enabling access to early adoption of postpartum contraceptive methods.

The nexus between maternal antenatal care attendance, newborn postnatal care and neonatal mortality in India: a matched case-control study

IntroductionOur study examines the relationship between newborn postnatal care and neonatal mortality stratified by maternal antenatal care attendance under a matched case-control framework.MethodsData from the fifth round of the National Family Health Survey was used. A total of 172,079 recent births to eligible women (15–49 years) in five years preceding the survey were included in the study. We used the conditional logistic regression model, a commonly used regression model to fit matched case-control data to examine the effects of newborn postnatal care on neonatal mortality. The mother’s age at birth of the newborn, previous birth intervals, birth order of the newborn, and birthsize of the newborn were included as the matching variables.ResultsNewborns receiving postnatal care within two days or more than two days of birth are less likely to die during the neonatal period. Preferences for newborn postnatal care were also observed to increase with more maternal antenatal care visits. Our study also found a lower risk of neonatal mortality among those newborns whose umbilical cord was examined within two days of birth, regardless of the number of maternal antenatal care visits. Similarly, the risk of newborn deaths was lower among babies whose body temperature was measured within two days of birth. The tendency to breastfeed their newborns within an hour after delivery was considerably higher among those births that occurred to mothers who had a higher number of maternal antenatal care visits. The risk of newborn deaths was also observed to be lower among those born in public or private healthcare facilities.ConclusionConsidering the cohesive nature of the relationship between neonatal mortality and maternal and child healthcare utilisation, strategic planning and management of the existing policies and programmes related to accessibility, availability, and affordability of maternal and child healthcare services is needed to achieve goal 3.2 of the Sustainable Development Goals. Promoting cost-effective measures such as continuous monitoring of the baby’s body temperature and umbilical cord care could also effectively help reduce neonatal mortality.

Socioeconomic inequalities of pregnancy termination among reproductive age women in Bangladesh: a decomposition analysis using demographic and health survey

ObjectivesUndergoing women of pregnancy termination (PT) significantly faces the problem of physical and mental health. This study aims to assess the prevalence and socioeconomic disparity factors of PT in Bangladesh. This study analyzed data from the 2017–18 Bangladesh Demographic and Health Survey. Researchers employed chi-square tests to identify relationships between categorical variables and logistic regression to pinpoint factors associated with PT. To assess the socioeconomic variation of PT, the analysis utilized concentration curves, concentration indices, and decomposition techniques.ResultsThe study found that 21.0% of reproductive-aged women in Bangladesh had ever terminated a pregnancy. Our study revealed that women from Chittagong and Sylhet regions, with wealthier backgrounds, aged 30 or older, employed in business, taking short birth intervals, and whose husband/partner was 35 or older, were more likely to have had a pregnancy termination with statistical significance (p < 0.05). Besides, concentration curves showed a higher prevalence of PT among wealthier women (CCI = 0.029, p < 0.001). Decomposition of this inequality revealed that a woman’s wealth status was the largest contributor (74.98%) to the observed disparities, followed by exposure to mass media (41.82%), place of residence (34.35%), occupation (24.81%), and preceding birth interval (6.53%). Our study recommended that, in mitigating the above disparities, we should foster open discussions about underlying factors contributing to PT in Bangladesh.

Determinants of short birth interval in Ethiopia: A multilevel analysis based on EDHS 2019, Ethiopia, 2023.

According to the World Health Organization and Ethiopian Demographic and Health Survey on birth spacing, there should be at least a two-year gap between conception and the first of two children born in quick succession. In poor nations like Ethiopia, resource issues were complex, making it difficult to get statistics for the entire country. However, by examining Ethiopian mini demographic and health survey data, we were able to provide data at the national level. The cross-sectional survey-based study was conducted in several of Ethiopia's administrative cities and nine regions. In the analysis, sampling weight was used to correct the survey's non-proportional sample distribution to strata and areas throughout the survey process and restore representative data. The study's household population was presented and described using descriptive statistics such as weighted frequencies and percentages. The statistically significant factors linked to frequent short birth intervals were found using a multivariable, multilevel logistic regression analysis. Overall, 4306 weighted multigravida mothers nested within 305 enumeration areas were included in the analysis. The respondents' mean (standard deviation) of the birth interval was 42.027(26.69). Higher-educated women had 12% lower odds of having a shorter pregnancy (AOR = 0.88; 95% CI: 0.35, 0.98) than women without higher education. The odds of a short birth interval were 3.04 times greater among women in the age category of 40-49 years at first marriage (AOR = 3.04; 95% CI: 1.08, 8.46) than among women in the age category of 15-19 years. This indicates that older women were most likely to have short birth intervals. In the multilevel logistic regression model, maternal age, maternal educational status, the wealth quintile index, use of contraceptives, duration of breastfeeding, and contextual regions were significantly associated with short birth intervals in Ethiopia.

How educational inequality affects family multichild behavior—evidence from super high schools

In a context characterized by the dual issues of educational inequality and problems with fertility, the internal relationship between these two factors requires further in-depth exploration. On the basis of data drawn from the China Family Panel Studies (CFPS) from 2010 to 2018, this paper investigates whether “super high schools” in cities represent a form of educational inequality, uses a combination of a two-way fixed effect model with the instrumental variable method to discuss the influence of this situation on family fertility and the corresponding transmission mechanism, develops a proportional risk regression model, and expands our understanding of the influence of educational inequality on the second-child birth interval. This study reveals that educational inequality significantly suppresses the number of family births and that the paths of action associated with this effect include both the explicit and implicit costs of education. The inhibitory effect of educational inequality on the number of family births varies according to urban grade, urban or rural classification, and the education levels attained by women. In addition to decreasing the number of family births, educational inequality increases the second-child birth interval. This paper not only enriches related research on family multichild behavior but also provides an educational reference for attempts to address the issue of continuously low fertility rates in China and establish a connection between population and educational economics.

Prevalence and factors associated with short birth interval in the semi-rural community of Kaya, Burkina Faso: results of a community-based survey

BackgroundA short birth interval adversely affects the health of mothers and children. This study aimed to measure the prevalence of short birth intervals and identify their associated factors in a semi-urban setting in Burkina Faso.MethodsWe conducted a cross-sectional study in which data were collected in households between May and October 2022. The dependent variable was the short birth interval (SBI), defined by the World Health Organization as the time between two live births. We performed a multilevel mixed-effects Poisson regression with robust variance to determine the factors associated with the SBI by reporting adjusted prevalence ratios (aPR) with a 95% confidence interval (CI).ResultsA total of 5544 birth intervals were recorded from 4067 women. A short birth interval was found in 1503 cases out of 5544, i.e., a frequency of 27.1%. The prevalence of short birth interval (time between two live births less than 33 months) was higher in never users of modern contraceptive users (aPR = 1.24; 95% CI [1.14–1.34] vs. previous users), in younger ages with aPR of 4.21 (95% CI [3.30–5.37]), 2.47 (95% CI [1.96–3.11]), and 1.45 (95% CI [1.16–1.81]), respectively for under 18, 18–24 years old, and 25–34 years old, compared to 35 and over. Childbirths occurring before the implementation of the maternal and infant free health care policy (aPR = 2.13; 95% CI [1.98–2.30]) and also before the free family planning policy (aPR = 1.53; 95% CI [1.28–1.81]) were more likely to have SBI. Women with low socio-economic positions were also more likely to have SBI.ConclusionThis study found a high SBI in Burkina Faso (more than one woman out of four). Our results have programmatic implications, as some factors, such as contraceptive practice and socioeconomic status, are modifiable. These factors need particular attention to lengthen birth intervals and, in turn, improve mother–child couple health by reducing short birth interval consequences.

Reducing stunting and underweight through mother’s birth spacing: evidence from Ghana

BackgroundResearchers over the years have underscored the role of birth spacing on maternal health, however, inadequate maternal repletion due to shorter birth intervals could also affect the health of the child. Even so, limited studies exist on the linkage between birth spacing and child nutrition. This study examines the association between birth spacing and child stunting and underweight using the 2014 Ghana Demographic and Health Survey.MethodsThe study sourced data on 1, 904 children less than 59 months from the 2014 Ghana Demographic and Health Survey. The study employed bivariate analysis and logistic regressions to establish the association between birth spacing, and child stunting and underweight.ResultsThe analyses reveal that childbirth spacing between 24 and 35 months (OR = 0.62, 95% CI: 0.38–0.99; p < 0.05), 36 to 47 months (OR = 0.42, 95% CI: 0.25–0.70; p < 0 0.01), and beyond 47 months (OR = 0.47, 95% CI: 0.28–0.78; p < 0.01) have lower odds of child stunting than children with birth spacing less than 24 months. Children with birth spacing between 24 and 35 months (OR = 0.53, 95% CI: 0.29–0.98; p < 0.05), 36 to 47 months (OR = 0.44, 95% CI: 0.22–0.90; p < 0.01) and beyond 47 months (OR = 0.49, 95% CI: 0.26–0.94; P < 0.05) have lower odds of being underweight than those with birth spacing less than 24 months.ConclusionThe study reveals that mothers with a birth spacing of at least two to three years compared to their counterparts with less than two years of birth spacing have lower odds of having a stunted and underweight child under age five. The study recommends that Ghana Health Service and other healthcare providers should educate mothers on the gains of birth spacing of at least two years on their children.

Undernutrition and its determinants among children aged 6–59 months in Southern Ethiopia

Malnutrition is responsible for over one-third of deaths among children under the age of five in low-and middle-income countries, including Ethiopia, and is largely preventable. The objective of this study was to determine the prevalence of undernutrition and its contributing factors among children aged 6–59 months in the Gedio zone of Southern Ethiopia. A community-based cross-sectional study design was used, and data were collected from 403 children and their mothers selected through random sampling technique. Anthropometric measures were converted to Z-scores using WHO-Anthro version 3.2.2 software. The prevalence of underweight, wasting, and stunting were 19.7% (95% CI 16-24%), 10% (95% CI 7–13%), and 49% (95% CI 44–54%) respectively. Low birth weight (AOR = 2.8, 95% CI (1.585–4.895), feeding non-diversified diet (AOR = 1.9, 95% CI (1.036–3.497), and being unvaccinated (AOR: 2.0; 95%CI (1.013–4.197) were significantly associated with being underweight. Family size of ≥ 5 (AOR = 4.4, CI (1.274–5.059), meal frequency of < 3 times per a day (AOR = 2.3, CI (1.037–5.024), and index birth interval of < 24 months (AOR = 2.2, CI (1.015–4.843) were significantly associated with wasting. Similarly, children aged ≥ 24 months (AOR = 2.8, CI (1.769–4.474), feeding non-diversified diet (AOR = 1.8, CI (1.153–2.894), total duration of breast-feeding < 12 months (AOR = 4.0, CI (2.547–6.429), and mothers BMI below 18.5 (AOR = 2.2, CI (1.328–3.718) were identified as a predictors of stunting. The study revealed significant levels of undernutrition, including underweight, wasting, and stunting, among children in the study area. Factors such as birth weight, dietary diversity score, and vaccine status were found to be strongly linked to underweight. Additionally, living in a large family, meal frequency, and birth interval were significantly associated with wasting. The age of the child, duration of breastfeeding, dietary diversity score, and maternal BMI status were also significantly linked to stunting. To address this issue, the study recommends promoting healthier feeding practices, dietary diversification, optimal breastfeeding, complete vaccination, wider birth intervals, and improving maternal nutrition to reduce undernutrition among children aged 6–59 months in the area. Implementing these measures could significantly improve the health of children in the study area.

Infectious and obstetric determinants of anemia among pregnant women in Southwest Ethiopia.

Anaemia, characterized by low red blood cell or haemoglobin levels, impairs oxygen transport in the body and poses a major global public health issue, particularly affecting pregnant women and children. This study focuses on identifying the factors contributing to anaemia among pregnant women receiving antenatal care (ANC) at Mizan-Tepi University Teaching Hospital (MTUTH) in southwest Ethiopia. A hospital-based unmatched case-control study was conducted from July 1 to August 30, 2022, involving 370 pregnant women (90 with anaemia and 280 without). Data collection included questionnaires, laboratory tests (Hgb and stool examination), and anthropometric measurements. SPSS version 21 was used for data analysis, with binary logistic regression identifying factors associated with anaemia. The significance level was set at a p-value <0.05. The study achieved a 100% response rate for both cases and controls. Factors identified as determinants of anaemia among pregnant women included malaria infection (AOR = 7.83, 95% CI: 3.89-15.8), hookworm infection (AOR = 2.73, 95% CI: 1.39-5.34), short birth interval (AOR = 7.11, 95% CI: 3.59-14.2), and history of unsafe abortion (AOR = 5.40, 95% CI: 2.46-11.8). This study found that malaria infection, hookworm infection, birth interval <33 months, and a history of unsafe abortion are factors contributing to anaemia in pregnant women. Strategies such as distributing insecticide-treated bed nets (ITNs) to combat malaria, improving sanitation, anthelmintic drugs, promoting family planning to prevent unwanted pregnancies and unsafe abortions, and providing preconception care can help reduce the incidence of anaemia.

Effect of Dietary Standardized Ileal Digestible Arginine to Lysine Ratio on Reproductive Performance, Plasma Biochemical Index, and Immunity of Gestating Sows.

The aim of this study was to determine the optimal SID Arg: Lys ratio for maximizing the reproductive performance, immunity and biochemical parameters of sows during gestation, the colostrum composition, and the performance of their offspring. A total of 174 multiparous sows were randomly allocated to five treatment groups varying in dietary SID Arg: Lys ratios (0.91, 1.02, 1.14, 1.25 and 1.38) through modification of the levels of Arg or alanine supplementation (the total level of nitrogen was the same in all treatments). The results showed that increasing the dietary SID Arg: Lys ratio increased the number of piglets born alive (p < 0.05, linear and quadratic). The number of stillborn piglets, the birth weight variation of born alive piglets, the birth interval (p < 0.05, linear and quadratic) and the number of mummies (p < 0.05, quadratic) reduced with increasing the dietary SID Arg: Lys ratio. Broken-line regression analysis indicated that the optimal SID Arg: Lys ratio requirement for gestating sows to maximize the number of piglets born alive was 1.25. The content of non-fat solid, total solid, protein, and energy in colostrum increased linearly and quadratically (p < 0.05) with increasing dietary SID Arg: Lys ratio. Additionally, when increasing the dietary SID Arg: Lys ratio, the concentration of IgA (p < 0.05, quadratic) and IgM (p < 0.05, linear and quadratic) of plasma increased at day 90 of gestation; IgG (p < 0.05, linear and quadratic) concentration increased at day 110 of gestation of sows. The dietary SID Arg: Lys ratio had an increasing effect (p < 0.05, linear and quadratic) on plasma insulin levels at day 90 of gestation. Furthermore, there were increases in plasma concentrations of nitric oxide and ornithine at day 110 of gestation, Arg at day 90 and 110 of gestation (p < 0.05, linear and quadratic) and total protein at day 110 of gestation (p < 0.05, linear) with increasing dietary SID Arg: Lys ratio. The results of our study indicated that increases in the dietary SID Arg: Lys ratio during gestation resulted in an increase in the number of piglets born alive, a decrease in birth intervals, and an improvement in immunity and colostrum composition. The optimal SID Arg: Lys ratio for gestating sows to maximize the number of piglets born alive was 1.25.

Prognosis of Anaemic Pregnant Women at the Gabriel Touré University Hospital in Bamako (Mali)

The aim was to assess the prognosis of anaemic pregnant women at the Gabriel Toure University Hospital in Bamako (Mali). Materials and Methods: This was a cross-sectional, descriptive and analytical study. It covered a period of 6 months and involved 432 patients. Results: the frequency of anaemia associated with pregnancy was 28.7% or 432 cases of anaemia among 1505 pregnant women. The mean age was 25.99 years with extremes of 15 and 45 years. Among them, the majority were housewives and constituted 77.8% of the workforce compared to only 4.9% of civil servants. The etiological factors often associated were: gestationity (3.52 with extremes of 1 and 11); primiges (29.20%); parity (3.26 with extremes of 1 and 11). The mean birth interval was 24.4 months with extremes of minus 6 months and 158 months. In 78.7% of cases, patients were transfused. The prognosis was characterized by a maternal mortality rate of 4.4% and a neonatal mortality rate of 33.3%. The mean length of hospital stay was 5.21 days. Conclusion: Anaemia in pregnant women is a pathology that causes maternal and neonatal mortality. The unavailability of blood products worsens the prognosis.

Variation in 10 year birth trajectories of mothers involved in family court care proceedings and their peers in England.

ObjectiveFamily court (FC) care proceedings decide on removing children from parental care in response to concerns about risks of harm. Courts and social care report frequent births, often after short birth intervals as a key problem among mothers presenting to FCs. ApproachWe used a cohort of mothers with a first live birth (FLB) between 2007 and 2019 to estimate the cumulative incidence of FC within 10 years and compare birth trajectories with peers. Results3,118,327 women (15-50 years) had a FLB, of whom 34,062 had FC involvement. Cumulative incidence of FC within 10 years from FLB was 1.3% (95% Confidence Interval [CI]; 1.3-1.3) overall but highest in mothers who were younger (6.7% if &lt;20 years), more deprived (2.5% in most deprived areas) and with morbidity (22.7% with learning or multiple disability, 12.8% with adversity-related injuries or 5.7% with mental health admissions). If followed for 10 years from FLB, 58.4% (8,889/15,229) of women with FC involvement had ≤2 deliveries, compared to 82.2% otherwise (1,007,365/1,225,163). If &lt;25years at FLB, women involved in FC had more deliveries than their peers (3+ deliveries: 47.8%, 5,853/12,255 vs 29.5%, 123,092/416,904), however, if 25+, they had fewer deliveries if involved in FC (1 delivery: 49.6% 1,475/2,974 vs 39.2% 316,976/808,259). Conclusions and ImplicationsAt-risk mothers may benefit from early, targeted health and social care interventions to prevent FC involvement. Birth data highlights variation in birth trajectories and dispels the stereotype of women involved in FCs having many children, particularly if older at FLB.

Creating an intergenerational cohort of mothers and their children using administrative data from health, education and social care in England (ECHILD)

ObjectiveMaternal physical, psychological, and social risk factors extend beyond impacting maternal wellbeing to significantly influence their children. Sibling dynamics also play a crucial role in individual development, health and wellbeing. We established a national intergenerational cohort of mothers and their children using administrative health, education and social care data in England (ECHILD). ApproachWe extracted 14.5 million baby records from hospital records for births between 1997-2022 and linked 13.6 million (94.1%) of these to delivery records of 8.0 million mothers using a validated probabilistic algorithm. We then identified clusters of mothers with only-children and mothers with sibling-children by identifying livebirths linked to the same mother. ResultsThe cohort captures 87.7% of all livebirths in England and includes mothers aged up to 37 and their children. We identified 4,086,648 mother-only-child clusters and 3,957,856 mother-sibling-children clusters. Compared with only-children, children with siblings were more likely to live in more deprived areas and have younger mothers, but were less likely to be overdue births (&gt;=42 weeks gestation), or to have very low birth weight (&lt;1500g). Among the mother-sibling-children clusters, sibship sizes varied between 2-15, with a mean of 2.4 children per mother. The median birth interval was 3.0 years. Conclusions and ImplicationsThis national cohort of 8 million mothers and their children (including 4.1 million mother-only-child and 4.0 million mother-sibling-children clusters) linked to hospital, education and social care data is an important resource for investigating the effects of maternal exposures, sibling dynamics and their interplay on individual development, health and wellbeing.

Proportion and Associated Factors of Adverse Birth Outcomes Among Women Who Gave Birth at Debre Markos General Hospital, East Gojjam Zone, Ethiopia, 2022: A Cross-Sectional Study

Background: Adverse birth outcomes are a common public health problem in the developing world, including Ethiopia. There are several indices of adverse birth outcomes, such as stillbirth, preterm birth, low birth weight, small for gestational age and congenital anomalies. Objective: This study aimed to determine the proportion and associated factors of adverse birth outcomes among women who gave birth at Debre Markos General Hospital. Methods: A health facility-based cross-sectional study was conducted from July 1 to August 1/2022 on laboring women who attended Debre Markos General Hospital. A total of 337 study participants were selected using a systematic sampling method. Data were collected through interviews with a structured questionnaire. Epi Data version 3.1 was used for data entry and analyzed using Statical Package for Social Sciences software. Bivariable and multivariable logistic regression analyses were employed; a P value of less than 0.05 was considered a statistically significant factor. Result: The overall proportion of this study showed that 26.1% of women had adverse birth outcomes; 7.7% stillbirths and 9.2% each preterm and low birth weights. Rural residence, no antenatal care, antepartum hemorrhage, pregnancy-induced hypertension, illiteracy, post term pregnancy, birth interval less than two years, and age less than 20 years were independently associated with adverse birth outcomes. Conclusion: In this study, the overall proportion of adverse birth outcomes was low compared to previous studies. Residence, no antenatal care follow-up, antepartum hemorrhage, pregnancy-induced hypertension, post term pregnancy, birth interval less than two years, illiteracy, and age less than 20 years were associated with adverse birth outcomes.

Early neonatal mortality in Ethiopia from 2000 to 2019: an analysis of trends and a multivariate decomposition analysis of Ethiopian demographic and health survey

BackgroundEarly neonatal deaths, occurring within the first six days of life, remain a critical public health challenge. Understanding the trends and factors associated with this issue is crucial for designing effective interventions and achieving global health goals. This study aims to examine the trends in early neonatal mortality in Ethiopia and identify the key factors associated with changes in early neonatal mortality over time.MethodsThis study utilized five consecutive Ethiopian Demographic and Health Survey datasets from 2000 to 2019. To investigate the trends and identify factors influencing changes in early neonatal mortality over time, conducted a trend analysis and a logit-based multivariate decomposition analysis. Data management and analyses were performed using STATA version 17/MP software. All analyses were weighted to account for sampling probabilities and non-response. Statistical significance was determined at a two-sided p-value threshold of less than 0.05.ResultThe analysis included a total of 12,260 weighted women from the 2000 survey and 5,527 weighted women from the 2019 survey. Over the study period, there was an overall downward trend in early neonatal mortality, decreasing from 34 deaths per 1000 live births in 2000 to 27 deaths per 1000 live births in 2019. The annual rate of reduction was estimated to be 1.03%. Approximately 45% of the observed decline in early neonatal mortality rate can be attributed to changes in population characteristics or endowments (E) during the study period. Factors such as the mother’s age, maternal education, marital status, preceding birth interval, types of pregnancy, and the sex of the child significantly contributed to the compositional change in the early neonatal mortality rate.ConclusionOver the past two decades, Ethiopia has seen a modest decline in early neonatal mortality, but this progress falls short of the Sustainable Development Goal (SDGs) targets. To achieve the SDGs, the Ministry of Health and its partners should intensify efforts to reduce early neonatal mortality. Strategies like preventing early/late pregnancies, promoting appropriate marriage timing, and prioritizing education could help further reduce early neonatal deaths. Further research is also needed to explore the factors driving this issue.

Fertility responses to short-term economic stress: Price volatility and wealth shocks in a pre-transitional settler colony

This paper examines the effects of short-term economic stress, captured by general price volatility and a negative wealth shock on short-run fertility behavior in the rural pre-transitional society of the Cape Colony. First, we link complete birth histories of settler women from the South African Families database to consumer price index data to examine the effect of price volatility on conceptions. Next, we link the same birth histories to slave owner and slave emancipation data to examine the effect of a negative wealth shock on conception. Upon slave emancipation in 1834, former slave owners received on average only between 40 and 50 % of the market value of their slaves as compensation, resulting in a substantial reduction in their wealth. Relying on event history models that look simultaneously at stopping and spacing, we do not find strong evidence in support of fertility control in response to general price volatility. We do find greater variance in birth interval lengths for former slaveholding households during and immediately after emancipation, suggesting that a negative wealth shock is associated with increased fertility limitation through postponement in this context.

Factors contributing to stillbirth in young hyper-prolific sows in a tropical free-farrowing system.

The present study investigated factors associated with the incidence of stillbirth in young hyper-prolific sows within free farrowing systems in tropical environments. A total of 714 live-born and 54 stillborn piglets from 57 Landrace × Yorkshire sows, with an average parity of 2.7 ± 1.0 (range: 1 - 4), were comprehensively investigated. Reproductive variables of the sows, including gestation length, farrowing duration, the total number of piglets born per litter, and the birth order and status of each piglet, were recorded. Differences in the physiological characteristics of live-born and stillborn piglets, such as birth interval, cumulative birth interval, body weight at birth, crown-rump length, body mass index (BMI), ponderal index (PI), meconium staining score, and the percentage of piglets with a broken umbilical cord, were analysed. Piglets were divided into four groups based on the quartiles of birth order (Q1-Q4). On average, the duration of farrowing was 173.3 ± 85.9 min, and the total number of piglets born and number of piglets born alive-per litter were 14.1 ± 3.8 and 12.5 ± 3.5, respectively. The incidence of stillbirth was 6.7% (54/801 piglets). The higher percentages of stillbirths were detected in sows with large litter sizes (≥17 piglets, 10.9%) compared to those with small (≤13 piglets, 6.1%) and moderate (14 - 16 piglets, 2.8%) litter sizes (p < .001). The incidences of stillbirth in Q3 and Q4 of the litters were higher than in Q1 and Q2 (p < .001). Compared to live-born piglets, stillborn piglets had higher cumulative birth interval (103.0 ± 3.71 vs. 142.4 ± 9.35 min, p < .001), BMI (17.1 ± 0.15 vs. 18.4 ± 0.39 kg/m2, p = .002), PI (63.7 ± 0.59 vs. 70.8 ± 1.59 kg/m3, p < .001), meconium staining scores (1.78 ± 0.04 vs. 2.04 ± 0.10, p = .021), and the percentage of piglets born with a ruptured umbilical cord (45.2% vs. 66.0%, p = .004). An increase in the incidence of stillbirth was detected at 60, 120, 150, 180, and ≥ 210 min after the first piglet was born, compared to those born within the first 30 min of farrowing (p < .05). In conclusion, the study found that stillbirths in young, hyper-prolific sows were linked to several factors: large litter sizes (≥17 piglets per litter), prolonged cumulative birth intervals (142.4 min), elevated BMI of 18.4 kg/m2, high PI values of 70.8 kg/m3, increased meconium staining scores, and a higher occurrence of ruptured umbilical cords. To reduce the risk of stillbirth, particularly among piglets with high body indices born later in the birthing process, it is recommended to enhance farrowing supervision for young sows, starting at a cumulative birth interval of 60 min.

DETERMINANTS OF STUNTING INCIDENTS IN SOUTHWEST ACEH

In Southwest Aceh, stunting is still in the vast category compared to other districts/cities in Aceh Province. Although various strategies have been implemented by the local government so that the percentage of stunting incidents can be reduced, these efforts are currently not running optimally. This research aims to determine the causes of stunting in children in the Southwest Aceh Regency. In general, this research is helpful as a reference framework to reduce the incidence of stunting for childbirths, especially in the Southwest Aceh Regency. This research uses a quantitative type of research with a case-control design. The population in this study were all toddlers in Southwest Aceh Regency, totalling 3,477 respondents. The sampling method used simple random sampling, with the number of samples in this study being 90 cases and 90 controls. The results of the study showed that there was the most dominant relationship between the mother's low education (OR=5.67; 95%CI=0.87-37.10; p=0.070), the mother's second pregnancy and the birth interval of the first child &lt;2 years (OR =14.79; 95%CI=3.97-55.10; p=0.0001), father's height &lt;162 cm (OR=6.53; 95%CI=0.86-49.71; p =0.070) and use of insect repellent (OR=6.43; 95%CI=1.70-24.25; p=0.006). A mother's second pregnancy with a birth interval of &lt;2 years is the most dominant factor in the incidence of stunting in Southwest Aceh. So it is hoped that the BKKBN, in collaboration with local health officials, the Health Service, Community Health Centers in Southwest Aceh, as well as village midwives in Southwest Aceh, will improve health promotion performance by providing education about family planning so that it can increase public knowledge about the importance of spacing pregnancies.

Effects of short inter-pregnancy/birth interval on adverse perinatal outcomes in Asia-Pacific region: A systematic review and meta-analysis.

Short inter-pregnancy or birth interval is associated with an increased risk of adverse perinatal outcomes. However, some emerging evidence questions this association and there are also inconsistencies among the existing findings. This study aimed to systematically review the evidence regarding the effect of short inter-pregnancy or birth intervals on adverse perinatal outcomes in the Asia-Pacific region. A comprehensive search of five databases was conducted targeting studies published between 2000 to 2023. Studies that reported on short inter-pregnancy or birth interval and examined adverse perinatal outcomes, such as low birthweight (LBW) preterm birth (PTB), small for gestational age (SGA), and neonatal mortality were included and appraised for methodological quality using the Joanna Briggs Institute critical appraisal tools. Three reviewers independently screened the studies and performed data extraction. Narrative synthesis and meta-analyses were conducted to summarise the key findings. A total of 41 studies that fulfilled the inclusion criteria were included. A short-interpregnancy interval was associated with an increased risk of low birthweight (odds ratio [OR] = 1.65; 95%CI:1.39, 1.95), preterm birth (OR = 1.50; 95%CI: 1.35, 1.66), and small for gestational age (OR = 1.24; 95%CI:1.09, 1.41). We also found elevated odds of early neonatal mortality (OR = 1.91; 95%CI: 1.11, 3.29) and neonatal mortality (OR = 1.78; 95%CI: 1.25, 2.55) among women with short birth intervals. This review indicates that both short inter-pregnancy and birth interval increased the risk of adverse perinatal outcomes. This underscores the importance of advocating for and implementing strategies to promote optimal pregnancy and birth spacing to reduce the occurrence of adverse perinatal outcomes. Reproductive health policies and programs need to be further strengthened and promote access to comprehensive family planning services and increase awareness about the importance of optimal pregnancy and birth spacing.