Risk of adverse pregnancy outcomes associated with short and long birth intervals in Bangladesh: evidence from six Bangladesh Demographic and Health Surveys, 1996–2014

Abstract

ObjectiveTo examine the effect of short (<36 months) and long (≥60 months) birth intervals on adverse pregnancy outcomes in Bangladesh.Design, setting and participantsWe analysed data from six Bangladesh Demographic and Health Surveys (1996–1997, 1999–2000, 2004, 2007, 2011 and 2014). We included all singleton non-first live births, most recently born to mothers within 5 years preceding each survey (n=21 382). We defined birth interval according to previous research which suggests that a birth interval between 36 and 59 months is the most ideal interval. Bivariate and multivariable analyses were conducted to obtain the crude and adjusted ORs (aOR) respectively to assess the odds of first-day neonatal death, early neonatal death and small birth size for both short (<36 months) and long (≥60 months) spacing between births.Main outcome measuresFirst-day neonatal death, early neonatal death and small birth size.ResultsIn the multivariable analysis, compared with births spaced 36–59 months, infants with a birth interval of <36 months had increased odds of first-day neonatal death (aOR: 2.11, 95% CI: 1.17 to 3.78) and early neonatal death (aOR: 1.58, 95% CI: 1.13 to 2.22). Compared with births spaced 36–59 months, infants with a birth interval of ≥60 months had increased odds of first-day neonatal death (aOR: 2.02, 95% CI: 1.10 to 3.73) and small birth size (aOR: 1.17, 95% CI: 1.02 to 1.34). When there was a history of any previous pregnancy loss, there was an increase in the odds of first-day and early neonatal death for both short and long birth intervals, although it was not significant.ConclusionsBirth intervals shorter than 36 months and longer than 59 months are associated with increased odds of adverse pregnancy outcomes. Care-providers, programme managers and policymakers could focus on promoting an optimal birth interval between 36 and 59 months in postpartum family planning.

Association of Short and Long Interpregnancy Intervals with Adverse Birth Outcomes: Evidence from a Cross-Sectional Study in Northwest China

“… 13 A previous investigation conducted in Bangladesh reported that IPIs of ≥60 months were associated with higher risks of small birth size and first-day neonatal deaths than IPIs of 36–59 months. 5 These findings were consistent with our results. This association had been questioned in some studies.…”

“… 4 LBW is associated with a high risk of perinatal mortality and contributes to up to 80% of neonatal mortality. 5 Birth defects and SGA increase the risks of early miscarriage, stillbirth, perinatal death, infant death, and congenital disabilities. 6 , 7 In addition, adverse birth outcomes are also related to subsequent health problems in offspring.…”

Incidence and determinants of neonatal near miss in south Ethiopia: a prospective cohort study

“…The current study found that neonates born with a birth interval of less than 24 months were more likely to develop NNM than those born at an interval of 24 months or more. Similar to these findings, previous studies conducted in low-and middle-income countries reported an association of neonatal death with birth intervals less than 24 months [22,43,44]. A study undertaken in Bangladesh reported that as the birth interval increases up to a minimum of 24 months, the risk of early neonatal deaths decreases [45].…”

A multilevel analysis of short birth interval and its determinants among reproductive age women in developing regions of Ethiopia

“…Globally, a birth interval of fewer than 18 months is associated with increased risk for neonatal mortality, infant mortality, under-five mortality, and maternal mortality [4,6,9,[15][16][17][18][19][20][21]. Similarly, Ethiopia has experienced a significant number of neonatal mortality and infant associated with short birth interval compared to the overall average rate of infant and neonatal mortality reported in Africa [18].…”