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Birth spacing and child mortality in Bangladesh and the Philippines
J E Miller1, J Trussell, A R Pebley
1Office of Population Research, Princeton University, NJ 08544.
Insights
Short birth intervals increase child mortality risk by 60-80%. This heightened risk for infants born less than 15 months apart is particularly pronounced for those of high birth order, even after accounting for other factors.
Area of Science:
- Demography
- Public Health
- Pediatrics
Background:
- Optimal birth spacing is crucial for maternal and child well-being.
- Previous research indicates potential risks associated with short interpregnancy intervals.
Purpose of the Study:
- To quantify the mortality risk for children born after short interpregnancy intervals.
- To identify specific subgroups and conditions under which these risks are most significant.
Main Methods:
- Analysis of demographic and health data from Bangladesh and the Philippines.
- Statistical modeling to control for confounding variables like prematurity, birth order, socioeconomic status, and maternal age.
- Stratified analysis to examine regional differences and specific risk periods.
Main Results:
- Children born within 15 months of a previous birth face a 60-80% higher mortality risk in the first two years of life, independent of prematurity.
- This elevated risk is concentrated among high birth order infants.
- The effect is observed in both countries, but the heightened risk is confined to the neonatal period in Bangladesh.
Conclusions:
- Short interpregnancy intervals pose a significant, independent risk factor for early childhood mortality, particularly for high birth order infants.
- Public health interventions promoting optimal birth spacing are essential for reducing child mortality.
- Further research may be needed to understand regional variations in the timing of these risks.
Abstract:
This analysis uses data from Bangladesh and the Philippines to demonstrate that children who are born within 15 months of a preceding birth are 60 to 80% more likely than other children to die in the first two years of life, once the confounding effects of prematurity are removed. The risks associated with short conception intervals are confined to children who are also high birth order; they persist in the presence of controls for prior familial child mortality, breast-feeding, mother's age, and socioeconomic status. In Bangladesh but not in the Philippines, these effects are confined to the neonatal period.