Effect of the interval between pregnancies on perinatal outcomes among white and black women

Zhu, Bao–Ping; Haines, Kathleen M.; Le, Thu; McGrath-Miller, Katherine; Boulton, Matthew L.

doi:10.1067/mob.2001.118307

Cited by 100 publications

(109 citation statements)

References 22 publications

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“…In addition, the length of the earlier birth intervals (those who have had many children are likely to have had them in short intervals) is important. A birth interval below two years tends to be a risk factor for a preterm or low birth weight delivery (Conde-Agudelo, Rosas-Bermudez, and Kafury-Goeta 2006; Smith, Pell, and Dobbie 2003;Zhu 2005;Zhu et al 2001;Rawlings, Rawlings, and Read 1995).…”

Section: Determinants Of Birth Weight and Estimation Strategymentioning

confidence: 99%

What has high fertility got to do with the low birth weight problem in Africa?

Kodzi¹,

Kravdal²

2013

DemRes

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BACKGROUNDThere has been much concern about adverse individual and societal consequences of high fertility in sub-Saharan Africa. One concern is that children of high birth orders may have low birth weight. However, the evidence for such an effect is not strong. OBJECTIVEOur objective is to investigate whether a woman's high parity status might increase her risks of having a baby with low birth weight. METHODSPooling 60 Demographic and Health Surveys data-sets from 32 sub-Saharan countries, we selected children of mothers who had at least two births of order two or higher within the five years preceding the surveys. We modeled the probability of having a child with low birth weight and controlled for all mother-specific, household, or community characteristics that are constant over the period of analysis, by including fixed-effects for the mother. We also controlled for salient factors including sex, maternal age, preceding birth interval, and whether prenatal care was received. RESULTSWe found no adverse effect of increasing parity on the odds of having a child with low birth weight at normative ranges; such effects only manifest at extremely high paritiesnine or more children. At moderately high parities, the chance of low birth weight is actually lower than at very low parities. CONCLUSIONSWhile high fertility may lead to various adverse outcomes for African families, low birth weight appears not to be among these outcomes. Other factors, such as adolescent childbearing, poverty, and inadequate prenatal care may be more important determinants of low birth weight in Africa.

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Section: Determinants Of Birth Weight and Estimation Strategymentioning

confidence: 99%

What has high fertility got to do with the low birth weight problem in Africa?

Kodzi¹,

Kravdal²

2013

DemRes

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“…1 Short interpregnancy intervals that result from unintended rapid repeat pregnancy increase the risk of adverse maternal-child health outcomes. 2,3 Identifying factors that are linked to unintended pregnancy in the postpartum period may help to explain socioeconomic and racial/ethnic disparities in maternal-child outcomes and guide interventions to reduce these disparities. Low educational status (LEdS; <12th grade completion or equivalence) has been recognized as a risk factor for unintended pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Unintended rapid repeat pregnancy and low education status: Any role for depression and contraceptive use?

Bennett¹,

Culhane

McCollum

et al. 2006

American Journal of Obstetrics and Gynecology

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Objective-The purpose of this study was to assess the contribution of depressive symptoms and poor contraceptive use early in the first postpartum year to the risk of unintended repeat pregnancy at the end of that year among adults with low educational status (< 12th grade or equivalence).Study design-This was a prospective observational cohort study of 643 sexually active, lowincome, inner-city adult women (age ≥ 19) who enrolled prenatally (14.7 ± 6.9 weeks gestational age) and were followed twice after delivery (3.3 ± 1.3 months and 11.0 ± 1.3 months). Associations were assessed by multivariate logistic regression.Results-Low educational status (odds ratio, 2.32; 95% CI, 1.25-4.33) and less effective contraceptive use (odds ratio, 2.31; 95% CI, 1.05-4.51) were associated with unintended pregnancy. Neither depressive symptoms nor contraceptive use reduced the risk of pregnancy that was associated with low educational status.Conclusion-Low educational status was associated with more than twice the risk of unintended pregnancy 1 year after delivery. We found no evidence that depression or poor contraceptive use mediate this relationship. KeywordsFertility control; Postpartum period; Educational status; Contraception; Depressive symptom; Pregnancy interval A disproportionately large number of unintended pregnancies in the United States occur among women from low-income minority populations. 1 Short interpregnancy intervals that result from unintended rapid repeat pregnancy increase the risk of adverse maternal-child health outcomes. 2,3 Identifying factors that are linked to unintended pregnancy in the postpartum period may help to explain socioeconomic and racial/ethnic disparities in maternal-child outcomes and guide interventions to reduce these disparities. Low educational status (LEdS; <12th grade completion or equivalence) has been recognized as a risk factor for unintended pregnancy. 1,4 However, the mechanisms that link LEdS and pregnancy intention have not been well-defined. Effective contraceptive use is critical for reducing the rates of unintended pregnancy. 5 LEdS has been associated with nonuse of contraception, the use of less effective contraception methods, increased contraceptive failure rates, and reduced adherence to treatment regimens for chronic illnesses. 6,7 Because of its association with both LEdS and the inconsistent use of medications that include contraception, depression might also contribute to the risk of unintended pregnancy. 8,9 Despite these findings, we are not aware of any analyses that directly assess the possible causal links between depression, contraceptive use, and unintended pregnancy in the postpartum period.In this study, we sought to fill a gap in research on disparities in pregnancy intention by directly examining the contribution of postpartum depressive symptoms and contraceptive use regarding the risk of unintended repeat pregnancy among women with LEdS. The specific goals of this study were to assess whether LEdS confers increased risk of unintended repea...

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“…2 Women who wait 18 to 23 months after delivery before conceiving their next child lower their risks of adverse perinatal outcomes, such as low birth weight, preterm birth, and small size for gestational age. 3,4 One objective of Healthy People 2010 is to reduce the proportion of births occurring within 24 months after a previous birth for women of all ages and to prevent second and repeat births during adolescence, regardless of the interval between births. Health care providers can help all new mothers understand that they can become pregnant again soon after delivery and should assist them with contraceptive education and supplies.…”

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confidence: 99%

Hawaii's Healthy Start Home Visiting Program: Determinants and Impact of Rapid Repeat Birth

et al. 2004

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ABSTRACT. Objective. Healthy People 2010 calls for reductions in rapid repeat births (RRBs), defined as births occurring within 24 months after a previous birth for women of all ages, and prevention of repeat births during adolescence, regardless of the birth interval. Home visiting has been promoted as a mechanism to prevent child abuse and neglect and to improve pregnancy outcomes. This study aims to assess the impact of home visiting in preventing RRB and its malleable determinants and assesses the influence of RRB on the mother and the index child. We hypothesized that maternal desire to have a RRB, access to a family planning site, and use of birth control would be significant malleable determinants and that the effects of the program in preventing RRB would be mediated through its influence on these variables. We also hypothesized that the occurrence of RRB would result in increased stress and family dysfunction, resulting in adverse maternal and child outcomes such as severe maternal stress, maternal neglect of the index child, decreased maternal warmth toward the index child, and increased behavior problems of the index child.Methods. The Healthy Start Program (HSP) is a home visiting program to prevent child abuse and neglect and to promote child health and development among newborns of families identified as being at risk for child maltreatment. This study was a randomized, controlled trial of Hawaii's HSP, in which eligible families were randomly assigned to home-visited and control groups. A total of 643 families at risk for child abuse were enrolled between November 1994 and December 1995. Data to measure RRB and malleable determinants were collected through structured maternal interviews and observation of the home environment. We measured RRB through maternal self-report by asking about a subsequent birth in follow-up interviews at 1, 2, and 3 years. To measure the malleable determinants, we measured the mother's desire for a RRB at baseline and at the 1-year interview and determined whether she had access to a family planning site. The mother was also asked which contraceptive methods she had ever used in the past and which methods, if any, she used in the year following the index child's birth. We measured 3 maternal parenting outcomes at the year 3 follow-up interview, ie, parenting stress, neglectful behavior toward the index child, and warmth toward the index child. We used odds ratios with 95% confidence intervals (CIs) to measure the strength of associations. Multiple logistic regression was used to assess 1) program effects on RRB and its malleable determinants, 2) the impact of the malleable determinants on RRB, and 3) the association between RRB and adverse maternal and child outcomes.Results Conclusions. Overall, 20% of the mothers in our sample of at-risk families had a RRB, which was far greater than the national average of 11%. RRB was associated with a greater likelihood of adverse consequences for both the mother and the index child. The lack of program effects can be traced to sho...

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Effect of the interval between pregnancies on perinatal outcomes among white and black women

Cited by 100 publications

References 22 publications

What has high fertility got to do with the low birth weight problem in Africa?

What has high fertility got to do with the low birth weight problem in Africa?

Unintended rapid repeat pregnancy and low education status: Any role for depression and contraceptive use?

Hawaii's Healthy Start Home Visiting Program: Determinants and Impact of Rapid Repeat Birth

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