Postpartum Amenorrhoea among Manipuri Women: A Survival Analysis

Abstract

Among the three major components of a closed birth interval, waiting time to conception can somehow be managed with effective contraceptives while gestation is universally constant in its duration; the duration of postpartum amenorrhoea (PPA) varies in complex nature. The present study aimed to investigate the proximate factors influencing the duration of PPA. A community-based, cross-sectional study was conducted in four valley districts of Manipur, India, during 1 August−31 December 2009, to analyze the differentials and determinants of duration of PPA, applying the survival analysis technique. In total, 1,225 ever-married women were selected through two-stage cluster sampling. The median duration of PPA was 5.7 months. Among the 11 explanatory variables of interest, only three variables—place of residence (p<0.05), infant mortality from preceding pregnancy (p<0.01), and duration of breastfeeding (p<0.01)—had a significant effect on the duration of PPA. The findings may be used as baseline information for future researchers and maternal health policy-makers.

Dynamics of Birth Interval Components in Manipur

“…Thus breast feeding and ovulation are antagonistic, because either prolactin or gonadotropins can not be produced simultaneously or prolactin blocks the action of gonadotropins, and hence resulting to depress the onset of ovulation. The present finding that lactational duration certainly delay the duration of post partum amenorrhoea is also supported by a number of studies (Srinivasan et Dissanyake (2000) and Singh (2012).…”

“…Most of their studies have clearly indicated a direct link between duration of breastfeeding and post partum amenorrhoea. But apart from breastfeeding, many researchers have shown that several socio-demographic factors affect the duration of post partum amenorrhoea (Nath et al, 1993;Mukherjee et al, 1994;Singh, 2007, Aryal, 2006, Singh et al, 2012.…”

Lactational amenorrhoea among adolescent girls in low-income and middle-income countries: a systematic scoping review

“…Singh et al reported that in bivariate analysis, duration of amenorrhoea appeared longer in the two categories of adolescents (<15 and 15-20 at time of marriage) compared with older women (p<0.01), but this association was no longer significant in multivariate analysis. 51 Haggerty and Rutstein, in their analysis of 37 countries in the early 1990s, report a wide variability in duration of amenorrhoea. 52 Sub-Saharan African countries had the longest durations of amenorrhoea; 14 of 18 countries had medians longer than a year.…”

“…Five studies were analytical, three of which reported findings from crude analysis 47 49 50 and two conducted multivariable analyses of the association between age and lactational amenorrhoea. 46 51 The remaining four studies presented descriptive analyses only, meaning they did not perform statistical tests of the differences between indicators of lactational amenorrhoea among adolescents and older women.…”

“…52 The most recent data available across the five studies examining duration of lactational amenorrhoea were collected in 2009 in India. 51 Theme 2: use of lactational amenorrhoea as a family planning method Four studies (from Bangladesh, Nigeria and Turkey) examined outcomes related to the use of lactational amenorrhoea as a family planning method among adolescents. Two of these studies included respondents who have never had a child together with those who have.…”