Interbirth interval and maternal anaemia in 21 sub-Saharan African countries: A fractional-polynomial analysis

Abstract

Background Maternal anaemia is a global public health problem contributing to adverse maternal and perinatal outcomes. In addition to other risk factors, interbirth interval has been identified as a potentially modifiable risk factor of maternal anaemia. However, the current evidence for the association between interbirth interval and maternal anaemia remains inconclusive. Hence, this study examined the association between the interbirth interval and maternal anaemia in sub-Saharan Africa. Methods We conducted a multinational cross-sectional study of interbirth interval (time between two singleton live births) and maternal anaemia (haemoglobin levels < 12 g/dl for non-pregnant women, < 11 g/dl for pregnant women) for 21 sub-Saharan African countries using the most recent nationally representative Demographic and Health Surveys, 2010–2017. A weighted multivariable fractional polynomial function was used to estimate the non-linear relationship between interbirth interval and maternal anaemia, considering interbirth interval as a continuous variable and adjusting for potential confounders. Analyses were stratified by reproductive classification (non-pregnant and pregnant women). Results There were 81,693 women included in the study (89.2% non-pregnant, 10.8% pregnant). Of all women, 32.2% were in their postpartum period. Overall, 36.9% of women had anaemia (36.0% of non-pregnant and 44.3% of pregnant women). Of the participants, 15% had a short interbirth interval (<24 months), and 16% had a long interbirth interval (≥ 60 months). We found that both short and longer interbirth intervals were associated with an increased risk of maternal anaemia in a dose-response fashion. Relatively a lower risk of maternal anaemia was observed between 24 and 40 months of interbirth intervals. Conclusions Our findings suggest that both short and longer interbirth intervals were associated with an increased risk of maternal anaemia in sub-Saharan Africa.

Determinants of anemia level among reproductive-age women in 29 Sub-Saharan African countries: A multilevel mixed-effects modelling with ordered logistic regression analysis

“…For instance, it was found that the pooled prevalence of anemia among reproductive-age women in SSA countries was 40.5% (95% CI = 40.2%-40.7%), which was almost consistent with the previous study in East Africa that reported the prevalence ranging from 40.7% to 42.9% [ 23 ]. However, our finding was higher than the studies in 21 SSA countries (36.9%) [ 34 ], Ethiopia (37.5%) [ 21 ], Uganda (32%) [ 32 ], Rwanda (19%) [ 31 ], and Pakistan (18%) [ 22 ]. This discrepancy could be partly explained by differences in the scope of the study and population.…”

Prevalence of anemia and its associated factors among pregnant women in Ilala Municipality - Tanzania: Analytical cross-sectional study

“…A short inter-pregnancy interval is said to hinder the restoration of the depleted maternal resources that are needed for the subsequent pregnancy and pose the risk of anemia, pregnancy-induced hypertension, premature rapture of the membranes, and others [40] Several observational studies have confirmed the association between the short inter-pregnancy interval and anemia. [40–42] Moreover, this study found that about 41.7% of pregnant women had a short inter-pregnancy interval. This raises concerns about family planning use among women of reproductive age in this setting, owing to the potential effect of a short inter-pregnancy interval on anemia.…”

Maternal Hemoglobin Levels as a Causative Factor in Incidence of Low Birth Weight Babies: A Public Health Prospective

“…Maternal anemia always related to higher risk of disadvantageous events related to birth and or health outcomes [47,48]. In parts of Africa [49,50], south Asia [48,51], and many more LMICs [52] actually had a higher merged anemia prevalence than did other Asian and upper-middle-income countries. Overall, in LMICs, 12% of low birth weight, 19% of preterm births, and 18% of perinatal mortality were related to maternal anemia [47].…”