Interpregnancy interval and risk of preterm birth and neonatal death: retrospective cohort study

Objective To determine whether a short interval between pregnancies is an independent risk factor for adverse obstetric outcome.Design Retrospective cohort study.Setting Scotland.Subjects 89 143 women having second births in 1992-8 who conceived within five years of their first birth.Main outcome measures Intrauterine growth restriction (birth weight less than the 5th centile for gestational age), extremely preterm birth (24-32 weeks), moderately preterm birth (33-36 weeks), and perinatal death.Results Women whose subsequent interpregnancy interval was less than six months were more likely than other women to have had a first birth complicated by intrauterine growth restriction (odds ratio 1.3, 95% confidence interval 1.1 to 1.5), extremely preterm birth (4.1, 3.2 to 5.3), moderately preterm birth (1.5, 1.3 to 1.7), or perinatal death (24.4, 18.9 to 31.5). They were also shorter, less likely to be married, and more likely to be aged less than 20 years at the time of the second birth, to smoke, and to live in an area of high socioeconomic deprivation. When the outcome of the second birth was analysed in relation to the preceding interpregnancy interval and the analysis confined to women whose first birth was a term live birth (n = 69 055), no significant association occurred (adjusted for age, marital status, height, socioeconomic deprivation, smoking, previous birth weight vigesimal, and previous caesarean delivery) between interpregnancy interval and intrauterine growth restriction or stillbirth. However, a short interpregnancy interval (< 6 months) was an independent risk factor for extremely preterm birth (adjusted odds ratio 2.2, 1.3 to 3.6), moderately preterm birth (1.6, 1.3 to 2.0), and neonatal death unrelated to congenital abnormality (3.6, 1.2 to 10.7). The adjusted attributable fractions for these associations were 6.1%, 3.9%, and 13.8%. The associations were very similar when the analysis was confined to married non-smokers aged 25 and above.Conclusions A short interpregnancy interval is an independent risk factor for preterm delivery and neonatal death in the second birth.     

Education and timing of parenthood among Canadian women: a cohort analysis.

This research examines factors associated with the timing of first birth in Canada, focusing primarily on the role of women's educational attainment. Proportional hazards modelling techniques are applied to data from the 1984 Canadian Fertility Survey (CFS) in order to determine how educational attainment, estimated as close as possible to the date of first birth, influences the timing of first birth and whether the importance of this variable varies according to age cohorts. The results suggest that among a number of variables useful for distinguishing different levels of risk, educational attainment proves to be the most important predictor in the model. Education exerts a substantial positive influence on birth timing for women of all age groups. As expected, moreover, significant cohort differences are also evident, with the greatest to the smallest impact on the risk from the youngest to the oldest cohorts. These clear-cut cohort differences indicate a fundamental change in the effects of education over time, a trend most likely resulting from substantial changes in both the content and social significance of formal schooling during the past few decades.     

Social-demographic influence on first birth interval in China, 1980-1992

This study examines the delay between first marriage and first live birth in China among a sample of women who married between 1980 and 1992. Most couples in China only use contraception after the first child is born. Most sample women had their first child within 2 years of marriage. However, there are significant rural-urban differences in the first birth interval, indicating that there was most probably deliberate fertility regulation after marriage among many urban couples. Survival analysis shows that place of residence, level of education, age at first marriage and marriage cohort affect the first birth interval.     

Son preference and fertility in China

This paper examines the effect of son preference on the hazards of having a second and a third birth. With data from the Two-per-thousand National Sample Survey on Fertility and Contraception conducted in 1988 by the State Family Planning Commission of China, the hazard of having a second birth among 62+ thousand married women who have had a first birth, and the hazard of having a third birth among 43+ thousand married women who have had two births was examined. These two hazards (i.e. the hazard of moving from the first to the second birth, and the hazard of moving from the second to the third birth) were analysed by estimating Cox proportional hazard models. The major covariate in the first analysis is whether or not the first-born was a daughter. In the second analysis the main covariate is whether both of the first two children were girls. In both models seven covariates known to have independent effects on the transition to a second (or third) birth are controlled for, namely, whether the woman is a Han, whether she is a farmer, her age at the birth of the first (or second) child, whether she had her first (or second) birth prior to the initiation in 1979 of the one-child policy, and three dummy variables reflecting her level of education. The results show the important influence of son preference on the hazard of having another birth.     

Determinants of birth intervals in Sudan

Using individual birth history data from the Sudan Fertility Survey, 1979, parity-related differences in fertility are demonstrated, as well as differences between socioeconomic groups. Rural women, women with no education and those married to uneducated husbands show rapid parity progression and its cumulative effects on fertility which are consistent over all birth intervals. Urban women, women with some education and those married to educated husbands, however, go rapidly through their second and third birth intervals and then more slowly at higher parities. A limitation of the study was the inability to control fully for the effects of breast-feeding and contraception. There is evidence for a reduction in high parity births, starting in the 1970s.     

Changes in the timing of births in Melbourne, Australia

2 10-year marriage cohorts from 2 surveys of married women in Melbourne were compared on their timing of the 1st and 2nd births. The results showed that women who were married in the early 1970s were much more likely to delay their first birth until about the 3rd or 4th year of marriage compared with women who married in the 1960s. This tendency to delay the 1st birth was probably aided by effective contraception, as it coincided with widespread use of the oral contraceptive. There was no difference in the timing of the 2nd birth in relation th the 1st birth between the 2 marriage cohorts. Women who delayed childbearing also preferred smaller families. Indeed, the increase in the % of women delaying childbearing appears to be synonymous with the trend toward the two-child family. Altough the number of married women in the labor force increased significantly from the early to the later cohort, a desire to work was not usually cited as the reason for delaying childbearing. Rather, economic reasons were most frequently mentioned for delaying childbearing.     

Duration between marriage and first birth and marital instability

This paper considers whether marital instability varies by the duration between marriage and 1st birth among ever-married white and black American women. Analysis of data from the June 1985 Current Population Survey suggests that the duration between marriage and 1st birth has a generally monotonic relationship with the probability of white women separating or divorcing from their 1st marriage; the relationship has remained relatively constant over time. For blacks, no consistent association is found between marital dissolution and the duration between marriage and 1st birth. Black women having a premarital conception and postmarital birth and those having their 1st birth during their 2nd year of marriage have a similarly high risk of dissolution. Conversely, blacks having their 1st birth 8-12 or 25-42 months after marrying have a low probability of dissolution. Childless women and those with premarital births generally has the greatest probability of marital disruption for whites. Racial differences may occur because blacks view the 1st birth and marriage differently than whites. That is, because blacks are much more likely to have premarital births and to have a shorter duration between marriage and 1st birth, blacks and whites in the same 1st birth interval category may be dissimilar and have different values resulting in a differential effect of the timing of the 1st birth on marital instability by race. Caution is needed when interpreting the pattern of association between delayed childbearing (and to a lesser extent, births occuring a few years after marriage) and marital instability. Results for whites were similar at each marriage duration and it is assumed delayed childbearing was not a result of marital instability. Marital instability was expected to have its strongest effect on the timing of the 1st birth during the 1st years of marriage. Marital instability may be partially responsible for the delaying of childbearing among blacks. However, blacks who delay but are married at 1st birth have a relatively low risk of separating or divorcing.     

Photoperiod control of birth timing in the harbour seal (Phoca vitulina)

The harbour seal ( Phoca vitulina ) has delayed implantation, precise annual birth timing, and significant latitudinal variation in birth timing. The birth timing patterns of four distinct groups of seals, including colonies of P. v. vitulina and colonies and captive individuals of P. v. richardsi , were examined using population-based photoperiod analysis to assess the role of photoperiod in setting annual birth timing. This analysis simultaneously determined the time, relative to birth, at which photoperiod response was likely to occur and the critical photoperiod.
Despite marked differences in birth timing patterns, a high level of agreement was found among groups for the timing of photoperiod response. The two subspecies, however, demonstrated significantly divergent critical photoperiods. Eastern Atlantic harbour seals were exposed to a common critical photoperiod of 11.7 h/day on the 268th pre-partum day. Wild Pacific harbour seals were exposed to 14.3 h/day on the 283rd pre-partum day. These times corresponded to the estimated occurrence of blastocyst implantation.
Using the above information, three small captive populations were subjected to artificially prolonged photoperiods during the period of embryonic diapause to test whether subsequent birth timing could be delayed. Technical difficulties invalidated results at two sites. At the third and largest colony, the mean pupping date of six individuals was significantly delayed by 10.7days.
The precision and latitudinal variation of annual birth timing in the harbour seal are due to a response to photoperiod which occurs immediately prior to blastocyst implantation. The critical photoperiod, however, is divergent among subspecies and, thus, has probably evolved allowing seasonal adaptation. Similar environmental signalling has been described for California sea lions and northern fur seals and represents the likely timing mechanism for most pinniped species.     

Effects of maternal birth season on birth seasonality in the Canadian population during the seventeenth and eighteenth centuries

Birth records of the French-Canadian population for the period 1621-1765 were analyzed retrospectively to examine the effect of maternal birth season on the seasonal distribution of births. Preliminary examination indicated that there was a bimodal pattern in birth seasonality: a major peak in early spring, a trough in early summer, a minor peak in autumn, and a trough around December. Because this seasonality was strongly biased at the level of the first birth by the month of marriage, which was concentrated in November, the seasonality of nonfirst births (n = 32,926) was examined in relation to the four seasons of maternal birth. Mothers born in May-July showed a flatter monthly distribution of nonfirst births at a maternal age of 28 years or more. Analysis of marriage-first birth intervals indicated that mothers who married in August-October showed a lower percentage of immediate conception (intervals of 8-10 months), whereas those mothers born in May-July had a higher percentage of immediate conception. This difference in birth seasonality shown by mothers born in May-July is similar to results from early twentieth-century Japan. Some seasonal infertility factors could have affected the embryos at the earliest stage of pregnancy, modifying a part of the seasonal variation in birth rate.     

Variation in size at birth and cigarette smoking during pregnancy

The influence of cigarette smoking during pregnancy and other familial factors on size at birth and gestation length is investigated among 458 births to 227 mothers living in a suburban community in the U.S. In this sample, 56% of the births were to mothers who reported not smoking during the pregnancy and 35% were to mothers who reported smoking 20 cigarettes or less. Multiple stepwise regression analysis was employed to examine the influence of cigarette smoking after statistical adjustment for such social and biological characteristics of the family as parents' sizes, education, income, and aspects of mother's reproductive history. After correction for significant social and biological characteristics, smoking status was a significant contributor to birth weight variation. In fact, cigarette smoking had the next-largest partial correlation coefficient (r = -0.26) second to gestation length. Birth length is also negatively associated with cigarette smoking, though not so strongly as is birth weight. The reduction in birth lengths can be attributed to the reduction in birth weights. Gestation length was not associated with cigarette smoking in this sample. The analysis of collinearity between smoking status and the other independent variables indicates that the effect of smoking appears to be independent of interrelationships among the independent variables.     

Measuring the childbearing motivation of couples referred to the Shiraz Health Center for premarital examinations

Millions of children who were born during the first decade after the Islamic revolution in Iran are now reaching the age of marriage and childbearing. Short spacing between marriage and the birth of the first child has the potential to cause an excessive and costly increase in the growth of population in Iran. Research into the motivations for the birth of first child among newly married couples can create a knowledge base that will enable health centres to help these couples make better decisions about the timing of their first pregnancy. Using a consecutive sampling technique and administering Miller's Childbearing Questionnaire, data were gathered regarding the childbearing motivations and desires of 300 couples who had been referred to the Shiraz Health Center for premarital counselling. The Childbearing Questionnaire, with some minor modifications, was found to be a valid and reliable instrument for measuring the childbearing motivations of newly married couples of Shiraz County, Fars Province, Iran. The utility of these findings for counselling in health centres is discussed. Based on the results, a longitudinal study is being designed that will allow the development of models for predicting the time of first pregnancy after marriage.     

The ecology of human birth seasonally

This article examines birth seasonality in two environmentally and ethnographically distinct societies: the Copper Inuit of the Central Canadian Arctic and the Samukundi Abelam of Papua New Guinea. Although the regions inhabited by these societies differ dramatically in degrees of seasonal variation, both populations display significant seasonality in conceptions and births. For the Copper Inuit, such seasonal variation was found to be the consequence of social and economic responses to extreme environmental change. Birth seasonality for the Samukundi Abelam is also pronounced and was determined to be the result of social ideologies which are only indirectly linked to environmental factors. The article also proposes a research paradigm designed to facilitate the cross-cultural investigation of birth seasonality in human populations.     

The unwanted pregnancy

A questionnaire was submitted to the mothers of 200 consecutively delivered infants; 15% of mothers were unmarried. The results showed a high prevalence of unwanted pregnancy, most accounted for by well educated, married women having their first or second baby, and despite access to contraceptive agents. Most of the married women and over 50% of the unmarried who had not wanted to become pregnant wanted the baby after its birth.     

Human sex ratio at birth and mother's birth season: multivariate analysis.

We used a population-based historical French Canadian database to examine the effects of mother's birth season on sex ratio at birth. Non-first births in the database (n = 127,658) were analyzed for their sex, parish size (2 large parishes of Montreal and Quebec or the other smaller parishes), time period (births up to 1719 or those from 1720), maternal age (< or = 24, 25-29, 30-34, 35+ years), sex of the preceding sibling (male or female), and birth seasons of the child and his or her parents (February-April, May-July, August-October, November-January). Season of child's birth significantly affected the sex ratio (chi 2 = 11.507, d.f. = 3, p = 0.009), with the births in February-April or May-July showing a lower sex ratio. Season of mother's birth also contributed highly significantly to the variation of sex ratio (chi 2 = 15.196, d.f. = 3, p = 0.002); mothers born in February-April had a low sex ratio among their children (sex ratio = 1.013). In contrast, season of father's birth did not affect the sex ratio (chi 2 = 0.618, d.f. = 3, p = 0.892). When a multiple logistic model was applied to the data, mother's birth season was the single most significant factor. The lower sex ratio from mothers born in February-April was observed consistently for every maternal age and delivery season. Seasonal influences on female fetuses seem to have changed their future reproductive characteristics.     

Genetic and environmental influences on human birth weight

Path-analytic techniques were used to demonstrate a significant influence of both fetal genes and maternal environment on birth weight in a sample of infants born to primarily white, middle-class, nonsmoking mothers. If the mother smoked before conception, however, the expression of the fetal birth-weight genes in males was significantly reduced. Multiparity was associated with an increase in genetic variance. This is the first report that genetic influences on birth weight are dependent on the environmental conditions imposed on the fetus by the mother.     

Height and marital outcomes in the Netherlands,birth years 1841-1900

Adult body height appears to be significantly associated with marital outcomes: taller men across contexts have been found to be more likely to be married, and more likely to be married at younger ages. We are interested in exploring both outcomes individually and simultaneously, while using an unique, individual-level dataset of Dutch men and their brothers born between 1841 and 1900. To do so, we exploit survival models and cure models. While survival models yield a single estimate for the hazard (or age at) marriage, cure models yield two: one for the likelihood of marriage, and one for the hazard of first marriage. Cure models thus account for selection into marriage, while survival models do not. We find that, in the survival analyses, being in the shortest 20 % of heights is associated with later ages of marriage, relative to being average height. However, when we account for selection into marriage with cure models, we find that height is no longer associated with age at marriage. Instead, we see that height is associated with the likelihood of being married, with being in the bottom 20 % of heights associated with a 56.1 % decreased likelihood of being married, relative to being average height. We therefore conclude that height may be a gatekeeper for access to marriage, but it appears that other factors – likely related to the ability to set up an independent household – are more important in determining the timing of marriage for our research population.     

Analyses of factors influencing the birth weight and neonatal growth rate of Cheetah (Acinonyx jubatus) cubs

Birth weight and the neonatal growth rate are reliable indicators of neonatal survival prospects. Data on weight at birth and consecutive weights until 40 days of age were recorded for cheetah cubs in 16 litters. Growth was found to be linear during the first 40 days of life. Weight data were used to evaluate the influence of several factors on birth weight and neonatal growth. The factors used in these analyses were sex, litter identity, litter size, average litter size over the first 40 days, birth weight, parents, gestation length, parity of the dam, and inbreeding. For birth weight and neonatal growth, litter identity was the major explanatory factor (81.8 and 85.3%). For birth weight, a significant influence of gestation length was found (p < 0.05), whereas inbreeding coefficient tended to decrease the birth weight (p = 0.09). Together, gestation length and inbreeding coefficient account for 57.5% of the between‐litter variation for birth weight. Factors with significant influences on neonatal growth are gestation length and parity (p < 0.05). The average litter size over the first 40 days tended to influence neonatal growth (p = 0.07). These three variables together account for 99.9% of the between‐litter variation for neonatal growth during the first 40 days of life. A comparison of neonatal growth between mother‐raised and hand‐raised cubs revealed a lower growth rate in hand‐raised cubs (45 vs. 27 g/day). Zoo Biol 18:129–139, 1999. © 1999 Wiley‐Liss, Inc.     

Covariates of age at first birth in Guyana: a hazards model analysis

Analysis of data from the Guyana Fertility Survey on the trends and covariates of age at 1st birth among various birth cohorts of women ever in union indicates that an early entry into union is associated with young age at 1st birth and higher number of children born. Multivariate analysis showed that women with higher education, urban residence, and entry into 1st birth compared to others, and that young women are delaying their 1st birth for longer durations than older women. Work status of women before 1st birth and the starting age of union seem to be the 2 major contributory factors for age at 1st birth. Noticeably, the role of education has changed and is now more significant among younger cohorts than among older ones for 1st birth timing.     

Influence of some sow characteristics on within-litter variation of piglet birth weight

Within-litter variation of piglet birth weight (BW0) is associated with an increased piglet mortality and a high variability in pig weight at weaning and weight or age at slaughter. Data collected in two experimental herds were used to quantify within-litter variability in BW0 and to assess the influence of factors mainly related to the sow. Within 24 h after birth, piglets born alive were individually weighed and stillborn piglets were collectively (first data set) or individually (second data set) weighed. The first data set was restricted to litters with no or only one stillborn piglet (3338 litters). It was used to assess the influence of genetic selection on BW0 variation by comparing litter characteristics before (1994 to 1996) and after (2001 to 2004) the development of hyperprolific sows in this herd. The second data set included all litters (n = 1596) from sows born between 2000 and 2004. For each litter, mean BW0 (mBW0) and its coefficient of variation (CVBW0) were calculated. Then, variance analyses were performed to test the influence of litter size, parity, year of sow birth and season at conception. Prolificacy improvement was associated with an increased CVBW0 in litters from pure Large White (LW) and Landrace × Large White (LR × LW) crossbred sows. The CVBW0 averaged 21% and was significantly influenced by litter size and parity. It increased from 15% to 24% when litter size varied from less than 10 piglets to more than 15 piglets. The proportion of small piglets (i.e. weighing less than 1 kg) increased concomitantly. The CVBW0 was not repeatable from a parity to the following. It was lowest for first and second parities (20%) and thereafter increased progressively. The CVBW0 was positively related to sow's backfat thickness gain during gestation. Taking into account litter size, parity, year of sow birth and season at conception explained 20% of BW0 variation. Thus, major part of heterogeneity is due to other factors, presumably including embryo genotype, on the one hand, and factors that influence embryo and foetus development, such as epigenetic factors, on the other hand.     

An evolutionary model of stature, age at first birth and reproductive success in Gambian women

We have built a model to predict optimal age at first birth for women in a natural fertility population. The only existing fully evolutionary model, based on Ache hunter-gatherers, argues that as women gain weight, their fertility (rate of giving birth) increases-thus age at first birth represents a trade-off between time allocated to weight gain and greater fertility when mature. We identify the life-history implications of female age at first birth in a Gambian population, using uniquely detailed longitudinal data collected from 1950 to date. We use height rather than weight as an indicator of growth as it is more strongly correlated with age at first birth. Stature does not greatly influence fertility in this population but has a significant effect on offspring mortality. We model age at first reproduction as a trade-off between the time spent growing and reduced infant mortality after maturation. Parameters derived from this population are fitted to show that the predicted optimal mean age of first birth, which maximizes reproductive success, is 18 years, very close to that observed. The reaction norm associated with variation in growth rate during childhood also satisfactorily predicts the variation in age at first birth.