Birth spacing and infant mortality in Brazil

The effects of birth spacing on neonatal and post-neonatal mortality in Brazil were found to be very consistent with models based on data from other South American countries. The model for neonatal mortality simplified to three significant variables, whereas the model for post-neonatal mortality included four significant interactions.     

Birth spacing,breastfeeding, and early child mortality in a traditional Indian society: A hazards model analysis

Abstract

There are few studies of the interrelationships among breastfeeding, child spacing, and child mortality in traditional societies that incorporate extensive controls for social and demographic characteristics of the mother and child. In this paper, we investigate the impact of breastfeeding and the length of the preceding birth interval on early child mortality (defined as a death in the first two years of life) using data from a traditional society of India. Multivariate hazards models are used to analyze the data. Most prior analyses related the impact of breastfeeding duration to the duration of child survivability by taking breastfeeding as a fixed covariate. The present study has a methodological focus in the sense that breastfeeding information from retrospective survey data is treated as a time‐dependent covariate both as a status variate as well as a duration—with empirical findings compared across the two specifications. The effects of postpartum amenorrhoea and various other demographic and socioeconomic characteristics of mother and child are also studied. The results suggest that breastfeeding duration has a strong impact in reducing the relative risk of early child mortality; but it does not explain the effect of the length of the preceding birth interval on early child mortality.     

Birth spacing in Pakistan

Life table analysis was applied to data from the 1975 Pakistan Fertility Survey to identify child spacing differentials between population subgroups. Women in urban areas had shorter birth intervals than their rural counterparts from parities 1-6; only after parity 7 was this differential reversed. Similarly, women with some education had shorter birth intervals at the earlier parities than uneducated women. While overall family size is relatively homogeneous in Pakistan, women of more modern backgrounds seem to space their children more closely than traditional women. Age at marriage appears to play an important role not only in determining the length of the 1st interval, but also that of subsequent intervals. An unexpected finding was that ever users of contraception had distinctly more rapid spacing of their births than never users. The median interval to 1st birth was shortest in North West Frontier Province, but similar in Punjab and Sind. Multiple classification analysis revealed that some differentials in child spacing by education, residence, and province persisted even after other variables were controlled. Cohort of mother had an independent effect, with younger cohorts having shorter birth intervals. However, the variable that had the strongest effect on length of interval (aside from the 1st interval) was breastfeeding duration. It is likely that increasing urbanization and improved levels of education among women will lead to high levels of marital fertility associated with shorter birth intervals. Even though these trends tend to increase the age at marriage, they are associated with shorter durations of breastfeeding. In the longer term, greater use of contraception among women in the modern sector may partially counteract the fertility increasing effect of reduced birth intervals.     

Effect of birth spacing on infant and child mortality in rural Nepal

This examination of the effect of birth spacing on infant and child mortality in rural Nepal is based on data from the Nepal Fertility Survey 1976 carried out by the Nepal Family Planning and Maternal Child Health Project in collaboration with the World Fertility Survey. The study confirms that the higher risk of infant death to 1st born children is mainly due to the higher proportion of younger women having 1st births, rather than due to their being 1st order births per se. The effect of maternal age on infant and child mortality is largely associated with birth interval. Previous birth interval, therefore, stands out as the most important factor affecting infant mortality; the next most important factor is the survival of the preceding child. A child born after an interval of less than 18 months since the previous live birth has a 31% higher risk of dying during infancy than 1 born after an interval of 1 1/2 to 2 years. The risk of the index child's dying is only 50% of that when its preceding sibling is dead. Neither education of mother nor education of father has a significant effect on infant mortality in rural Nepal.     

Birth spacing and infant mortality: evidence for eighteenth and nineteenth century German villages

Data from an historical population in which fertility control was minimal and modern health services were mostly unavailable are used to show that there appears to have been a strong association between previous birth interval length and infant mortality, especially when the previous child survived. Although only imperfect proxies for breast-feeding practices and other potentially confounding factors are available for this population, the results suggest that the association between previous interval length and infant mortality in this population is not solely, or primarily, a function of differences in breast-feeding behaviour or socioeconomic status. Other factors, e.g. maternal depletion or sibling competition, are more likely to explain the observed association.     

Anticipated child loss to migration and sustained high fertility in an east Caribbean population.

Development today is commonly accompanied by rapid urbanization and, where possible, high rates of migration to industrialized countries. At the same time, the expected demographic transition has often not materialized despite decreases in death rates. Child-to-woman ratios in St. Vincent and the Grenadines are related to the educational attainment of women in a census district, the percentage of men engaged in agriculture, whether the district has direct access to the outside world through a port or airport, and, when the other variables are controlled, the stability of a district's population. Those districts with the greatest stability of population had the lowest child-to-woman ratios, suggesting that the anticipated loss of children to migration may be an important factor in maintaining high reproductive rates.     

Birth spacing patterns in humans and apes

Comparative studies of birth interval dynamics in wild primates suffer from several problems of analysis and interpretation: (1) the data are always right-censored, (2) sample sizes are usually small, (3) the distribution of birth intervals is expected to be non-normal, (4) early offspring mortality is a confounding variable, and (5) differences in life history (e.g., presence or absence of menopause) can complicate interpretation of the results. A survival analysis designed to minimize these problems is applied to published data on wild chimpanzees and gorillas from Gombe and Virunga Parks, respectively, and to new data on wild orangutans from Tanjung Puting National Park and on a human population, the Gainj of highland Papua New Guinea. According to this analysis, the estimated median birth interval (when the offspring whose birth opens the interval does not die within the interval) is 43.3 +/- 1.0 months for the Gainj, 45.5 +/- 1.2 months for gorillas, 66.6 +/- 1.3 months for chimpanzees, and 92.6 +/- 2.4 months for orangutans.     

Birth weight and other determinants of infant and child mortality in three provinces of China

Information on levels, trends and determinants of infant and child mortality was available from the 1985 In-depth Fertility Survey which was conducted in three provinces of China. Mortality of children below age 5 varied from 49 per 1000 live births in Shaanxi to 20 in Shanghai in 1980-85 and has declined substantially since 1960, from 206 in Shaanxi and 66 in Shanghai. Male mortality was considerably higher than female mortality in the neonatal and post-neonatal period, and at ages 1-5 years. Birth weight, place of residence and mother's education were found to be important determinants of mortality; age of mother and parity were less important.     

Birth spacing in langur monkeys (Presbytis entellus)

This paper presents 10 years of reproductive data on birth interval length and 5 years of data on reproductive behavior postpartum from a captive colony of gray langur monkeys (Presbytis entellus)housed in Berkeley, California. Birth intervals of females following different pregnancy and nursing schedules are compared. Females whose infants survive to the age of 9 months have a median birth interval of 15.4 months. The experimental separation of mothers from infants for a period of 2 weeks, 6 to 9 months postpartum, had no significant effect on the median birth interval length. Females experiencing a pregnancy failure or the loss of a neonate had median birth intervals of 9.6 and 10.7 months, respectively. These intervals were significantly shorter than the birth intervals of females whose infants survived to 9 months, showing that the presence of a nursing infant delays the female’s time to next conception by approximately 5 to 6 months. Females experienced a median of three estrous periods (two estrous cycles) before conceiving postpartum, regardless of pregnancy outcome or length of infant survival, and females rarely conceived during their first estrous period postpartum. Weaning did not occur until after the mother’s next conception. These data indicate that, in populations of langurs characterized by average birth intervals of 15 to 16 months, the loss of an infant after the age of 5 to 6 months will not accelerate a female’s ability to conceive or shorten the birth interval length. The available data on birth spacing from populations of free-ranging langurs are reviewed. It could not be demonstrated that non-Himalayan populations are characterized by birth intervals which are as long as 20 to 24 months. Rather, it is suggested that female langurs inhabiting seasonally arid sites, such as Jodhpur, Abu, and Dharwar, may be capable of producing infants on the average of every 15 to 16 months. Flexibility in the timing of births and the lack of well-defined birth seasons at these sites may be explained by this species’ dietary and digestive adaptations. Additionally, data on birth spacing and the age of missing infants from the above field sites, where it has been suggested that infanticide following changes in male leadership occurs habitually, do not lend support to the sexual selection hypothesis of infanticide as proposed by S. Hrdy (1974, 1977).     

Infant and child mortality in rural Egypt.

This research examines determinants of infant and child mortality in rural Egypt, primarily the effects of household economic status and the availability of health services. Certain features of the health service environment affect survival in the neonatal period. In early childhood, survival chances improve markedly as income increases and if the household depends almost exclusively on employment income. In infancy and in early childhood, mortality is strongly associated with region of residence and maternal demographic characteristics, and is weakly associated with parental schooling.     

Association between stress and blood pressure variation in a Caribbean population

Based on the work of Selye (The Stress of Life, New York: McGraw-Hill, 1976) it is hypothesized that stress can produce physiological abnormalities, i.e., elevated blood pressure, and that social variables can be used as indicators or risk factors for disease. It is theorized that deviations from acceptable social patterns or traditional life-styles can produce stressful conditions that are associated with disease and that these situations can be demonstrated by examination of certain social characteristics. This association is examined among the Black Caribs of St. Vincent, West Indies. The social variables included in this analysis are marital status (single, married, widowed, or separated), frequency of church attendance (frequently, sometimes, seldom, or never), years of education, and number of children (for women only). The findings show that single individuals have higher pressures than married subjects and that males who never attend church have higher pressures than men who frequently attend church; a relationship was not demonstrated for females. Among males, as the years of education increased, blood pressure also increased, but for females, increased education was associated with lower pressures. Family size was not associated with systolic or diastolic pressure. The analysis of these selected social variables suggests that these variables influence male systolic and diastolic pressures, but only female diastolic pressure.     

Determinants of child mortality in south-west Uganda.

Anthropometric and sociodemographic variables were taken from 4320 children in a baseline survey carried out in March-April 1988 in the district of Mbarara, south-west Uganda. After 12 months a follow-up survey assessed the mortality of the children during the preceding year. Lack of ownership of cattle, recent arrival in the village, using candles for lighting, being of birth order higher than 5 and having a father with less than 8 years of schooling were significantly associated with child mortality. The addition of mid-upper arm circumference significantly improved the logistic model of socioeconomic variables and mortality and did not diminish the predictive power of socioeconomic variables in relation to increased mortality. This suggests that nutritional status and specific socioeconomic factors are both, independently, important predictors of child mortality.     

Infant and child mortality in Bangladesh

Socioeconomic differences and trends in infant and child mortality in Bangladesh are examined using data from the 1975 World Fertility Survey and 1979 Contraceptive Prevalence Survery. There is evidence of some recent decline in infant mortality and child mortality. Logit analysis of infant and child mortality indicates that sociodemographic variables such as mother's education, recent period, or higher birth orders, has significant independent effects upon the reduction of infant and child mortality. Other variables such as fetal loss, father's education, or land ownership had no consistent significant effect. On the other hand the effect of urban residence on infant and child mortality was positive after the control of sociodemographic variables. Mere concentration on the supply of modern medical services may bring limited returns unless they are reinforced by appropriate social changes, in particular those affecting the socioeconomic status of women. Educated mothers are likely to belong to higher income households, have better knowledge of how to care for children, and can bring more resources to the care of a sick child.     

Birth weight from pregnancies dated by ultrasonography in a multicultural British population.

OBJECTIVE--To produce standard curves of birth weight according to gestational age validated by ultrasonography in the British population, with particular reference to the effects of ethnic origin. DESIGN--Retrospective analysis of computerised obstetric database. SETTING--Three large maternity units associated with Nottingham University with over 16,000 deliveries a year. PATIENTS--41,718 women with ultrasound dated singleton pregnancies and delivery between 168 and 300 days'' gestation. MAIN OUTCOME MEASURES--Length of gestation, ethnic origin, parity, maternal height and weight at booking, smoking during pregnancy; the effect of these variables on birth weight. RESULTS--Birth weights from ultrasound dated pregnancies have a higher population mean and show less flattening of the birthweight curve at term than those of pregnancies dated from menstrual history. Significant differences were observed in mean birth weights of babies of mothers of European origin (3357 g), of Afro-Caribbean origin (3173 g), and from the Indian subcontinent (3096 g). There were also significant interethnic differences in length of gestation, parity, maternal height, booking weight, and smoking habit which affected birth weight. The ethnic differences in birth weight were even greater when the effect of smoking was excluded. CONCLUSIONS--Birthweight standards require precise dating of pregnancy and should describe the population from which they were derived. In a heterogeneous maternity population the accurate assessment of an individual baby''s weight needs to take the factors which affect birthweight standards into consideration.