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Pattern and determinant factors of birth intervals among Iranian women: a semi-parametric multilevel survival model

Published online by Cambridge University Press:  29 October 2019

Maryam Seyedtabib ,
Abbas Moghimbeigi ,
Mahmood Mahmoudi ,
Reza Majdzadeh  and
Hossein Mahjub Open the ORCID record for Hossein Mahjub [Opens in a new window]
Maryam Seyedtabib
Affiliation:
Department of Biostatistics & Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
Abbas Moghimbeigi
Affiliation:
Modeling of Noncommunicable Diseases Research Center, Department of Biostatistics & Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
Mahmood Mahmoudi
Affiliation:
Department of Health Services, Science and Research Branch, Islamic Azad University, Tehran, Iran
Reza Majdzadeh
Affiliation:
Iranian Institute for Health Sciences Research, Tehran University of Medical Sciences, Tehran, Iran
Hossein Mahjub*
Affiliation:
Department of Biostatistics & Epidemiology, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
*
*Corresponding author. Email: [email protected]
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Abstract

The interval between successive pregnancies (birth interval) is one of the main indexes used to evaluate the health of a mother and her child. This study evaluated birth intervals in Iran using data from the Iranian Multiple Indicators Demographic and Health Survey (IrMIDHS) conducted in 2010–2011. A total of 20,093 married Iranian women aged 15–54 years from the whole country constituted the study sample. Based on the nature of sampling and the unobserved population heterogeneity for birth intervals in each city and province, a multilevel survival frailty model was applied. Data were analysed for women’s first three birth intervals. The median first and second birth intervals were 30.3 and 39.7 months respectively. Higher education, Caesarean delivery, contraceptive use and exposure to public mass media were found to decrease the hazard rate ratio (HRR) of giving birth. Meanwhile, higher monthly income increased the hazard of giving birth. The results suggest that public mass media can play an effective role in encouraging women to have the recommended birth interval. Furthermore, increasing family income could encourage Iranian couples to decrease the time to their next birth.

Keywords

Birth intervalSurvival analysisMultilevel model
Type
Research Article
Information
Journal of Biosocial Science , Volume 52 , Issue 4 , July 2020 , pp. 534 - 546
Copyright
© Cambridge University Press 2019

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References

Abdel-Tawab, N, Lūzā, SF and Zaki, A (2008) Helping Egyptian Women Achieve Optimal Birth Spacing Intervals through Fostering Linkages Between Family Planning and Maternal/Child Health Services. Frontiers in Reproductive Health, Population Council.CrossRefGoogle Scholar
Adhikari, R (2010) Demographic, socio-economic, and cultural factors affecting fertility differentials in Nepal. BMC Pregnancy Childbirth 10(1), 19.CrossRefGoogle ScholarPubMed
Aghajanian, A (1995) A new direction in population policy and family planning in the Islamic Republic of Iran. Asia-Pacific Population Journal 10(1), 3.CrossRefGoogle ScholarPubMed
Aghajanian, A and Merhyar, AH (1999) Fertility, contraceptive use and family planning program activity in the Islamic Republic of Iran. International Family Planning Perspectives 25(2), 98–102.CrossRefGoogle Scholar
Akter, S and Rahman, MM (2010) Duration of breastfeeding and its correlates in Bangladesh. Journal of Health, Population and Nutrition 28(6), 595–601.CrossRefGoogle ScholarPubMed
Altindag, O (2016) Son preference, fertility decline, and the non-missing girls of Turkey. Demography 53(2), 541–566.CrossRefGoogle Scholar
Antai, D and Moradi, T (2010) Urban area disadvantage and under-5 mortality in Nigeria: the effect of rapid urbanization. Environmental Health Perspectives 118(6), 877.CrossRefGoogle ScholarPubMed
Asgharpour, M, Villarreal, S, Schummers, L, Hutcheon, J, Shaw, D and Norman, WV (2017) Inter-pregnancy interval and pregnancy outcomes among women with delayed childbearing: protocol for a systematic review. Systematic Reviews 6(1), 75.CrossRefGoogle ScholarPubMed
Austin, PC (2017) A tutorial on multilevel survival analysis: methods, models and applications. International Statistical Review 85(2), 185–203.CrossRefGoogle ScholarPubMed
Babalola, S and Fatusi, A (2009) Determinants of use of maternal health services in Nigeria – looking beyond individual and household factors. BMC Pregnancy and Childbirth 9(1), 43.CrossRefGoogle ScholarPubMed
Barber, JS and Axinn, WG (2004) New ideas and fertility limitation: the role of mass media. Journal of Marriage and Family 66(5), 1180–1200.CrossRefGoogle Scholar
Biks, GA, Berhane, Y, Worku, A and Gete, YK (2015) Exclusive breast feeding is the strongest predictor of infant survival in Northwest Ethiopia: a longitudinal study. Journal of Health, Population and Nutrition 34(1), 9.CrossRefGoogle ScholarPubMed
Breierova, L and Duflo, E (2004) The Impact of Education on Fertility and Child Mortality: Do Fathers Really Matter Less Than Mothers? National Bureau of Economic Research, Cambridge.CrossRefGoogle Scholar
Cheng, K-W (2011) The effect of contraceptive knowledge on fertility: the roles of mass media and social networks. Journal of Family and Economic Issues 32(2), 257–267.CrossRefGoogle ScholarPubMed
Chowdhury, AH and Karim, A (2013) Patterns and differentials of birth intervals in Bangladesh. Global Journal of Science Frontier Research Interdisciplinary 13(2), 11–24.Google Scholar
Clark, S (2000) Son preference and sex composition of children: evidence from India. Demography 37(1), 95–108.CrossRefGoogle ScholarPubMed
Conde-Agudelo, A, Rosas-Bermudez, A, Castaño, F and Norton, MH (2012) Effects of birth spacing on maternal, perinatal, infant, and child health: a systematic review of causal mechanisms. Studies in Family Planning 43(2), 93–114.CrossRefGoogle ScholarPubMed
Conde-Agudelo, A, Rosas-Bermúdez, A and Kafury-Goeta, AC (2006) Birth spacing and risk of adverse perinatal outcomes: a meta–analysis. JAMA 295(15), 1809–1823.CrossRefGoogle ScholarPubMed
Conde-Agudelo, A, Rosas-Bermúdez, A and Kafury-Goeta, AC (2007) Effects of birth spacing on maternal health: a systematic review. American Journal of Obstetrics and Gynecology 196(4), 297–308.CrossRefGoogle ScholarPubMed
CSA (2012) Ethiopia Demographic and Health Survey 2011. Central Statistical Agency, Addis Ababa, Ethiopia and ICF International, Calverton, MD, USA.Google Scholar
Das Gupta, M, Zhenghua, J, Bohua, L, Zhenming, X, Chung, W and Hwa-Ok, B (2003) Why is son preference so persistent in East and South Asia? A cross-country study of China, India and the Republic of Korea. Journal of Development Studies 40(2), 153–187.CrossRefGoogle Scholar
Davis, EM, Babineau, DC, Wang, X, Zyzanski, S, Abrams, B, Bodnar, LM and Horwitz, RI (2014) Short inter-pregnancy intervals, parity, excessive pregnancy weight gain and risk of maternal obesity. Maternal and Child Health Journal 18(3), 554–562.CrossRefGoogle ScholarPubMed
Dietl, A, Cupisti, S, Beckmann, M, Schwab, M and Zollner, U (2015) Pregnancy and obstetrical outcomes in women over 40 years of age. Geburtshilfe und Frauenheilkunde 75(8), 827.Google ScholarPubMed
Dodoo, FNA and Tempenis, M (2002) Gender, power, and reproduction: rural–urban differences in the relationship between fertility goals and contraceptive use in Kenya. Rural Sociology 67(1), 46–70.CrossRefGoogle Scholar
Erfani, A (2017) Curbing publicly-funded family planning services in Iran: who is affected? Journal of Family Planning and Reproductive Health Care 43(1), 37–43.CrossRefGoogle ScholarPubMed
Erfani, A and McQuillan, K (2008) Rapid fertility decline in Iran: analysis of intermediate variables. Journal of Biosocial Science 40(3), 459–478.CrossRefGoogle ScholarPubMed
Erfani, A and McQuillan, K (2014) The changing timing of births in Iran: an explanation of the rise and fall in fertility after the 1979 Islamic Revolution. Biodemography and Social Biology 60(1), 67–86.CrossRefGoogle ScholarPubMed
Erfani, A, Nojomi, M and Hosseini, H (2017) Prolonged birth intervals in Hamedan, Iran: variations and determinants. Journal of Biosocial Science 50(4), 1–15.Google ScholarPubMed
Gautam, S and Jeong, H-S (2019) The role of women’s autonomy and experience of intimate partner violence as a predictor of maternal healthcare service utilization in Nepal. International Journal of Environmental Research and Public Health 16(5), 895.CrossRefGoogle ScholarPubMed
Gutierrez, RG (2002) Parametric frailty and shared frailty survival models. Stata Journal 2(1), 22–44.CrossRefGoogle Scholar
Hemminki, E (1996) Impact of caesarean section on future pregnancy – a review of cohort studies. Paediatric and Perinatal Epidemiology 10(4), 366–379.CrossRefGoogle ScholarPubMed
Hemminki, E, Graubard, BI, Hoffman, HJ, Mosher, WD and Fetterly, K (1985) Cesarean section and subsequent fertility: results from the 1982 National Survey of Family Growth. Fertility and Sterility 43(4), 520–528.CrossRefGoogle ScholarPubMed
Hesketh, T, Lu, L and Xing, ZW (2011) The consequences of son preference and sex-selective abortion in China and other Asian countries. Canadian Medical Association Journal 183(12), 1374–1377.CrossRefGoogle ScholarPubMed
Higgins, JA, Popkin, RA and Santelli, JS (2012) Pregnancy ambivalence and contraceptive use among young adults in the United States. Perspectives on Sexual and Reproductive Health 44(4), 236–243.CrossRefGoogle ScholarPubMed
Hornik, R and McAnany, E (2001) Theories and evidence: mass media effects and fertility change. Communication Theory 11(4), 454–471.CrossRefGoogle Scholar
Hutti, MH (2005) Social and professional support needs of families after perinatal loss. Journal of Obstetric, Gynecologic & Neonatal Nursing 34(5), 630–638.CrossRefGoogle ScholarPubMed
Khamenei, SA (2014) Ayatollah Ali Khamenei on Iran’s Population Policy. Population and Development Review 40(3), 573–575.Google Scholar
Klebanoff, MA (1999) The interval between pregnancies and the outcome of subsequent births. New England Journal of Medicine 340(8):643–644.CrossRefGoogle ScholarPubMed
Kleinbaum, DG and Klein, M (2010) Survival Analysis, Vol. 3. Springer.Google Scholar
Kulu, H (2013) Why do fertility levels vary between urban and rural areas? Regional Studies 47(6), 895–912.CrossRefGoogle Scholar
McCrary, J and Royer, H (2011) The effect of female education on fertility and infant health: evidence from school entry policies using exact date of birth. American Economic Review 101(1), 158–195.CrossRefGoogle ScholarPubMed
McDonald, P, Hosseini-Chavoshi, M, Abbasi-Shavazi, MJ and Rashidian, A (2015) An assessment of recent Iranian fertility trends using parity progression ratios. Demographic Research 32, 1581–1602.CrossRefGoogle Scholar
Mahmood, S, Zainab, B and Latif, AM (2013) Frailty modeling for clustered survival data: an application to birth interval in Bangladesh. Journal of Applied Statistics 40(12), 2670–2680.CrossRefGoogle Scholar
Mansoorian, MK (2008) Determinants of birth interval dynamics in Kohgylooye and Bovairahmad province, Iran. Journal of Comparative Family Studies 39(2), 165–185.CrossRefGoogle Scholar
Mills, M, Rindfuss, RR, McDonald, P and Te Velde, E (2011) Why do people postpone parenthood? Reasons and social policy incentives. Human Reproduction Update 17(6), 848–860.CrossRefGoogle ScholarPubMed
Mohammadi Farrokhran, E, Mahmoodi, M, Mohammad, K, Rahimi, A, Majlesi, F and Parsaeian, M (2013) Study of factors affecting first birth interval using modified Gompertz cure model in west Azarbaijan province, Iran. Iranian Journal of Epidemiology 9(1), 41–51.Google Scholar
Najafi-Vosough, R, Soltanian, AR and Fayyazi, N (2017) Influence factors on birth spacing and childbearing rates using survival recurrent events model and parity progression ratios. Journal of Research in Health Sciences 17(3), e00384.Google ScholarPubMed
Noroozian, M (2012) The elderly population in Iran: an ever growing concern in the health system. Iranian Journal of Psychiatry and Behavioral Sciences 6(2), 1.Google ScholarPubMed
Office of the Deputy for Social Affairs (2004) The First Millennium Development Goals Report 2004: Achievements and Challenges. Office of the Deputy for Social Affairs, Management and Planning Organization of Iran, Tehran.Google Scholar
Pandian, Z, Bhattacharya, S and Templeton, A (2001) Review of unexplained infertility and obstetric outcome: a 10 year review. Human Reproduction 16(12), 2593–2597.CrossRefGoogle ScholarPubMed
Pine Yeakey, M, Muntifering, CJ, Ramachandran, DV, Myint, Y, Creanga, AA and Tsui, AO (2009) How contraceptive use affects birth intervals: results of a literature review. Studies in Family Planning 40(3), 205–214.CrossRefGoogle Scholar
Porter, M, Bhattacharya, S, van Teijlingen, E and Templeton, A (2003) Does Caesarean section cause infertility? Human Reproduction 18(10), 1983–1986.CrossRefGoogle ScholarPubMed
Puri, S, Adams, V, Ivey, S and Nachtigall, RD (2011) “There is such a thing as too many daughters, but not too many sons”: a qualitative study of son preference and fetal sex selection among Indian immigrants in the United States. Social Science & Medicine 72(7), 1169–1176.CrossRefGoogle ScholarPubMed
Rabbi, AF (2012) Mass media exposure and its impact on fertility: current scenario of Bangladesh. Journal of Scientific Research 4(2), 383–383.CrossRefGoogle Scholar
Rashidian, A, Karimi-Shahanjarini, A, Khosravi, A, Elahi, E, Beheshtian, M, Shakibazadeh, Eet al. (2014) Iran’s multiple indicator demographic and health survey – 2010: study protocol. International Journal of Preventive Medicine 5(5), 632.Google ScholarPubMed
Saha, UR and van Soest, A (2013) Contraceptive use, birth spacing, and child survival in Matlab, Bangladesh. Studies in Family Planning 44(1), 45–66.CrossRefGoogle ScholarPubMed
Salehi-Isfahani, D, Abbasi-Shavazi, MJ and Hosseini-Chavoshi, M (2010) Family planning and fertility decline in rural Iran: the impact of rural health clinics. Health Economics 19(S1), 159–180.CrossRefGoogle ScholarPubMed
Singh, AS (2016) Human fertility behavior through birth interval models: overview. American Journal of Theoretical and Applied Statistics 5(3), 132–137.CrossRefGoogle Scholar
Singh, SN, Singh, SN and Narendra, R (2011) Demographic and socio-economic determinants of birth interval dynamics in Manipur: a survival analysis. Online Journal of Health and Allied Sciences 9(4).Google Scholar
Smith, GC, Pell, JP and Bobbie, R (2003) Caesarean section and risk of unexplained stillbirth in subsequent pregnancy. The Lancet 362(9398), 1779–1784.CrossRefGoogle ScholarPubMed
Smith, GC, Wood, AM, Pell, JP and Dobbie, R (2006) First cesarean birth and subsequent fertility. Fertility and sterility 85(1), 90–95.CrossRefGoogle ScholarPubMed
Solheim, KN, Esakoff, TF, Little, SE, Cheng, YW, Sparks, TN and Caughey, AB (2011) The effect of cesarean delivery rates on the future incidence of placenta previa, placenta accreta, and maternal mortality. Journal of Maternal, Fetal & Neonatal Medicine 24(11), 1341–1346.CrossRefGoogle ScholarPubMed
Sonfield, A, Hasstedt, K, Kavanaugh, ML and Anderson, R. (2013) The Social and Economic Benefits of Women’s Ability to Determine Whether and When to have Children. Guttmacher Institute, New York.Google Scholar
Spong, CY, Berghella, V, Wenstrom, KD, Mercer, BM and Saade, GR (2012) Preventing the first cesarean delivery: summary of a joint Eunice Kennedy Shriver national institute of child health and human development, society for maternal–fetal medicine, and American college of obstetricians and gynecologists workshop. Obstetrics and Gynecology 120(5), 1181.CrossRefGoogle ScholarPubMed
Swanson, KM, Karmali, ZA, Powell, SH and Pulvermakher, F (2003) Miscarriage effects on couples’ interpersonal and sexual relationships during the first year after loss: women’s perceptions. Psychosomatic Medicine 65(5), 902–910.CrossRefGoogle ScholarPubMed
Tarekegn, SM, Lieberman, LS and Giedraitis, V (2014) Determinants of maternal health service utilization in Ethiopia: analysis of the 2011 Ethiopian Demographic and Health Survey. BMC Pregnancy and Childbirth 14(1), 161.CrossRefGoogle ScholarPubMed
Toohill, J, Fenwick, J, Gamble, J and Creedy, DK (2014) Prevalence of childbirth fear in an Australian sample of pregnant women. BMC Pregnancy and Childbirth 14(1), 275.CrossRefGoogle Scholar
Vahidnia, F (2007) Case study: fertility decline in Iran. Population and Environment 28(4–5), 259–266.CrossRefGoogle Scholar
Wang, K, Yau, KK, Lee, AH and McLachlan, GJ (2007) Multilevel survival modelling of recurrent urinary tract infections. Computer Methods and Programs in Biomedicine 87(3), 225–229.CrossRefGoogle ScholarPubMed
Wendt, A, Gibbs, CM, Peters, S and Hogue, CJ (2012) Impact of increasing inter-pregnancy interval on maternal and infant health. Paediatric and Perinatal Epidemiology 26(s1), 239–258.CrossRefGoogle ScholarPubMed
World Health Organization (2006) Report of a WHO Technical Consultation on Birth Spacing: Geneva, Switzerland 13–15 June 2005. World Health Organization. URL: https://apps.who.int/iris/handle/10665/69855 (accessed 26 August 2019).Google Scholar
Yohannes, S, Wondafrash, M, Abera, M and Girma, E (2011) Duration and determinants of birth interval among women of child bearing age in Southern Ethiopia. BMC Pregnancy and Childbirth 11(1), 38.CrossRefGoogle ScholarPubMed
Zamawe, CO, Banda, M and Dube, AN (2016) The impact of a community driven mass media campaign on the utilisation of maternal health care services in rural Malawi. BMC Pregnancy and Childbirth 16(1), 21.CrossRefGoogle ScholarPubMed