Dataset Information

Duration of birth interval and its predictors among reproductive-age women in Ethiopia: Gompertz gamma shared frailty modeling.

ABSTRACT:

Background

The World Health Organization recommended a minimum of 33 months between consecutive live births to reduce the incidence of adverse pregnancy outcomes. Poorly spaced pregnancies are associated with poor maternal and child health outcomes such as low birth weight, stillbirth, uterine rupture, neonatal mortality, maternal mortality, child malnutrition, and maternal hemorrhage. However, there was limited evidence on the duration of birth interval and its predictors among reproductive-age women in Ethiopia. Therefore, this study aimed to investigate the duration of birth interval and its predictors among reproductive-age women in Ethiopia.

Methods

A secondary data analysis was conducted based on the 2016 Ethiopian Demographic and Health Survey data. A total weighted sample of 11022 reproductive-age women who gave birth within five years preceding the survey was included for analysis. To identify the predictors, the Gompertz gamma shared frailty model was fitted. The theta value, Akakie Information Criteria (AIC), Bayesian Information Criteria (BIC), and deviance was used for model selection. Variables with a p-value of less than 0.2 in the bi-variable analysis were considered for the multivariable analysis. In the multivariable Gompertz gamma shared frailty analysis, the Adjusted Hazard Ratio (AHR) with a 95% Confidence Interval (CI) was reported to show the strength and statistical significance of the association.

Results

The median inter-birth interval in Ethiopia was 38 months (95% CI: 37.58, 38.42). Being living in Addis Ababa (AHR = 0.15, 95% CI: 0.03, 0.70), being rural resident (AHR = 1.13, 95% CI: 1.01, 1.23), being Muslim religious follower (AHR = 6.53, 95% CI: 2.35, 18.18), having three birth (AHR = 0.51, 95% CI: 0.10, 0.83), having four birth (AHR = 0.30, 95% CI: 0.09, 0.74), five and above births (AHR = 0.10, 95% CI: 0.02, 0.41), and using contraceptive (AHR = 2.35, 95% CI: 1.16, 4.77) were found significant predictors of duration of birth interval.

Conclusion

The length of the inter-birth interval was consistent with the World Health Organization recommendation. Therefore, health care interventions that enhance modern contraceptive utilization among women in rural areas and Muslim religious followers would be helpful to optimize birth interval.

SUBMITTER: Tesema GA

PROVIDER: S-EPMC7894930 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Duration of birth interval and its predictors among reproductive-age women in Ethiopia: Gompertz gamma shared frailty modeling.

Tesema Getayeneh Antehunegn GA Worku Misganaw Gebrie MG Teshale Achamyeleh Birhanu AB

PloS one 20210219 2

<h4>Background</h4>The World Health Organization recommended a minimum of 33 months between consecutive live births to reduce the incidence of adverse pregnancy outcomes. Poorly spaced pregnancies are associated with poor maternal and child health outcomes such as low birth weight, stillbirth, uterine rupture, neonatal mortality, maternal mortality, child malnutrition, and maternal hemorrhage. However, there was limited evidence on the duration of birth interval and its predictors among reproduc ...[more]

PMID: 33606724

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Project description:BackgroundShort inter-pregnancy interval is a public health concern because it results in adverse perinatal outcomes such as postpartum hemorrhage, anemia, premature birth, low birth weight, and perinatal deaths. Although it is critical to understand the factors that contribute to short inter-pregnancy interval to reduce the risk of these negative outcomes, adequate evidence about the factors in the urban context is lacking. Therefore, we aimed to assess the duration of the inter-pregnancy interval and its predictors among pregnant women in urban South Ethiopia.MethodsA community-based retrospective follow-up study was conducted among 2171 pregnant women in five geographically diverse urban settings in South Ethiopia. For the analysis, a Cox gamma shared frailty (random-effect) model was used. Adjusted hazard ratio (AHR) with a 95% CI was used to assess significant predictors. The median hazard ratio (MHR) used to report clustering effect.ResultsThe median duration of the inter-pregnancy interval was 22 months, 95% CI (21, 23), with an inter-quartile range of 14 months. Maternal age ≥30 years [AHR = 0.75, 95% CI: 0.58, 0.97], having no formal education [AHR = 0.60, 95% CI: 0.46, 0.78], contraceptive non-use [AHR = 2.27, 95% CI: 1.94, 2.66], breastfeeding for <24 months [AHR = 4.92, 95% CI: 3.95, 6.12], death of recent child [AHR = 2.90, 95% CI: 1.41, 5.97], plan pregnancy within 24 months [AHR = 1.72, 95% CI: 1.26, 2.35], lack of discussion with husband [AHR = 1.33, 95% CI: 1.10, 1.60] and lack of husband encouragement about pregnancy spacing [AHR = 1.25, 95% CI: 1.05, 1.48] were predictors of short inter-pregnancy interval. Adjusting for predictors, the median increase in the hazard of short inter-pregnancy interval in a cluster with higher short inter-pregnancy interval is 30% [MHR = 1.30, 95% CI: 1.11, 1.43] than lower cluster.ConclusionsIn the study settings, the duration of the inter-pregnancy interval was shorter than the World Health Organization recommendation. There is a need to improve contraceptive use and breastfeeding duration to maximize the inter-pregnancy interval. Men's involvement in reproductive health services and advocacy for women's reproductive decision-making autonomy are fundamental. The contextual disparities in the inter-pregnancy interval suggests further study and interventions.

Project description:BACKGROUND:Birth interval duration is an important and modifiable risk factor for adverse child and maternal health outcomes. Understanding the spatial distribution of short birth interval, an inter-birth interval of less than 33 months, and its predictors are vital to prioritize and facilitate targeted interventions. However, the spatial variation of short birth interval and its underlying factors have not been investigated in Ethiopia. OBJECTIVE:This study aimed to assess the predictors of short birth interval hot spots in Ethiopia. METHODS:The study used data from the 2016 Ethiopia Demographic and Health Survey and included 8,448 women in the analysis. The spatial variation of short birth interval was first examined using hot spot analysis (Local Getis-Ord Gi* statistic). Ordinary least squares regression was used to identify factors explaining the geographic variation of short birth interval. Geographically weighted regression was used to explore the spatial variability of relationships between short birth interval and selected predictors. RESULTS:Statistically significant hot spots of short birth interval were found in Somali Region, Oromia Region, Southern Nations, Nationalities, and Peoples' Region and some parts of Afar Region. Women with no education or with primary education, having a husband with higher education (above secondary education), and coming from a household with a poorer wealth quintile or middle wealth quintile were predictors of the spatial variation of short birth interval. The predictive strength of these factors varied across the study area. The geographically weighted regression model explained about 64% of the variation in short birth interval occurrence. CONCLUSION:Residing in a geographic area where a high proportion of women had either no education or only primary education, had a husband with higher education, or were from a household in the poorer or middle wealth quintile increased the risk of experiencing short birth interval. Our detailed maps of short birth interval hot spots and its predictors will assist decision makers in implementing precision public health.

Project description:BackgroundShort Birth Interval negatively affects the health of both mothers and children in developing nations, like, Ethiopia. However, studies conducted to date in Ethiopia upon short birth interval were inconclusive and they did not show the extent and determinants of short birth interval in developing (Afar, Somali, Gambella, and Benishangul-Gumuz) regions of the country. Thus, this study was intended to assess the short birth interval and its determinants in the four developing regions of the country.MethodsData were retrieved from the Demographic and Health Survey program official database website (http://dhsprogram.com). A sample of 2683 women of childbearing age group (15-49) who had at least two alive consecutive children in the four developing regions of Ethiopia was included in this study. A multilevel multivariable logistic regression model was fitted to identify the independent predictors of short birth interval and Akaike's Information Criterion (AIC) was used during the model selection procedure.ResultsIn this study, the prevalence of short birth interval was 46% [95% CI; 43.7%, 47.9%]. The multilevel multivariable logistic regression model showed women living in rural area [AOR = 1.52, CI: 1.12, 2.05], women attended secondary education and above level [AOR = 0.27, CI: 0.05, 0.54], have no media exposure [AOR = 1.35, CI: 1.18, 1.56], female sex of the index child [AOR = 1.13, CI:1.07,1.20], breastfeeding duration [AOR = 0.79, CI: 0.77, 0.82], having six and more ideal number of children [AOR = 1.14, CI: 1.09, 1.20] and having preferred waiting time to birth two years and above [AOR = 0.86, CI: 0.78, 0.95] were the predictors of short birth interval.ConclusionsThe prevalence of short birth intervals in the developing regions of Ethiopia is still high. Therefore, the government of Ethiopia should work on the access of family planning and education in rural parts of the developing regions where more than 90% of the population in these regions is pastoral.

Project description:BackgroundShort birth interval is a universal public health problem resulting in adverse fetal, neonatal, child and maternal outcomes. In Ethiopia, more than 50% of the overall inter birth spacing is short. However, prior scientific evidence on its determinants is limited and even then findings are inconsistent.MethodsA community -based unmatched case-control study was employed on 218 cases and 436 controls. Cases were ever married reproductive age women whose last delivery has been in the past five years with birth interval of less than 3 years between the latest two successive live births whereas those women with birth interval of 3-5 years were taken as controls. A multistage sampling technique was employed on 30% of the kebeles in Dessie city administration. A pre-tested interviewer based questionnaire was used to collect data by 16 trained diploma nurses and 8 health extension workers supervised by 4 BSc nurses. The collected data were cleaned, coded and double entered into Epi-data version 4.2 and exported to SPSS version 22. Binary logistic regression model was considered and those variables with P<0.25 in the bivariable analysis were entered in to final model after which statistical significance was declared at P< 0.05 using adjusted odds ratio at 95% CI.ResultIn this study, contraceptive use (AOR = 11.2, 95% CI: 5.95-21.15), optimal breast feeding for at least 2 years (AOR = 0.098, 95% CI:0.047-0.208), age at first birth <25 years (AOR = 0.36, 95% CI: 0.282-0.761), having male preceding child (AOR = 0.46, 95% CI: 0.166-0.793) and knowing the duration of optimum birth interval correctly (AOR = 0.45, 95% CI: 0.245-0.811) were significant determinants of short birth interval.ConclusionContraceptive use, duration of breast feeding, age at first birth, preceding child sex and correct understanding of the duration of birth interval were significant determinants of short birth interval. Fortunately, all these significant factors are likely modifiable. Thus, the existing efforts of optimizing birth interval should be enhanced through proper designation and implementation of different strategies on safe breastfeeding practice, modern contraceptive use and maternal awareness about the health merits of optimum birth interval.

Project description:BackgroundEarly neonatal death caused by preterm birth contributes the most for perinatal death. The prevalence of preterm birth continues to rise and is a significant public health problem. The exact cause of preterm birth is yet unanswered, as mostly preterm birth happens spontaneously. Predictors of preterm birth in developing countries like Ethiopia were not well investigated, and no study was conducted before this in the study area.ObjectivesTo identify predictors of preterm birth in Western Ethiopia, 2017/2018.MethodsHealth facility-based unmatched case-control study was conducted from October 20/2017-march 20/2018 in 4 Hospitals. A total sample size of 358 women was recruited. From this 72 were cases and 286 were controls. Cases were mothers who gave Preterm birth, and controls were mothers who gave birth at term. Ethical clearance was obtained from Wollega University ethical review committee. A pre tested, structured questionnaire was used to collect data. Data entry and analysis was done using Epi Data 3.1 and SPSS version 21, respectively. Logistic regression was done to identify predictors of preterm birth.ResultThree hundred fifty-eight women participated in this study of which 72 were cases and 286 were controls; making the overall response rate of 100%. Lack of antenatal care visit [AOR = 3.18, 95% CI 1.37-7.38]),(Having 1-2 antenatal care visit [AOR = 2.27, 95% CI 1.18-4.35]),history of previous preterm)[AOR = 5.19, 95% CI1.29-20.88],Short Interpregnancy Interval [AOR = 4.41.95% CI 2.05-9.47],Having Reproductive tract infections [AOR = 2.54, 95% CI 1.02-6.32] and having Obstetric complications [AOR = 2.48,95% CI 1.31-4.71] were found to be predictors of preterm birth.Conclusion and recommendationRisk factors of preterm delivery are multifactorial and depend on geographical and demographic features of the population studied. Hence results of studies from one area might not be applicable to another area. Antenatal care visits are unique opportunities for early diagnosis and treatment of problems. Therefore, antenatal care should be strengthened, and appropriate counseling should be given at each antenatal care follow up. Maintainning optimum birth interval through family planning, and early identification and treatment of reproductive tract infections are mandatory.

Dataset Information

Duration of birth interval and its predictors among reproductive-age women in Ethiopia: Gompertz gamma shared frailty modeling.

Background

Methods

Results

Conclusion

Publications

Duration of birth interval and its predictors among reproductive-age women in Ethiopia: Gompertz gamma shared frailty modeling.

Similar Datasets

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