TY - JOUR
T1 - The associations of birth intervals with small-for-gestational-age, preterm, and neonatal and infant mortality
T2 - A meta-analysis
AU - Kozuki, Naoko
AU - Lee, Anne Cc
AU - Silveira, Mariangela F.
AU - Victora, Cesar G.
AU - Adair, Linda
AU - Humphrey, Jean
AU - Ntozini, Robert
AU - Black, Robert E.
AU - Katz, Joanne
N1 - Funding Information:
We would like to thank Neff Walker for his invaluable contributions to the study design, interpretation of findings, and drafting of the manuscript, and the CHERG SGA-Preterm Birth working group for their feedback. The Brazil studies will also like to acknowledge Fernando Barros. Funding was provided by the Bill & Melinda Gates Foundation (810-2054) by a grant to the US Fund for UNICEF to support the activities of the CHERG. Investigators were offered financial support for analysis via subcontracts by the US Fund for UNICEF. The funding sources of the individual studies are as follows: Philippines (1983) - NIH, Nestle’s Coordinating Center for Nutritional Research, Wyeth International, Ford Foundation, US National Academy of Science, World Health Organization (WHO), Carolina Population Center, USAID; Zimbabwe (1997) – Canadian International Development Agency, USAID, Bill and Melinda Gates Foundation, Rockefeller Foundation, BASF; Brazil (1982) - International Development Research Center for Canada, WHO, UK Overseas Development Administration; Brazil (1993) - UN Development Fund for Women; Brazil (2004) – Wellcome Trust. The funders played no role in the manuscript.
Funding Information:
The publication costs for this supplement were funded by a grant from the Bill & Melinda Gates Foundation to the US Fund for UNICEF (grant 43386 to “Promote evidence-based decision making in designing maternal, neonatal, and child health interventions in low-and middle-income countries”). The Supplement Editor is the principle investigator and lead in the development of the Lives Saved Tool (LiST), supported by grant 43386. He declares that he has no competing interests. This article has been published as part of BMC Public Health Volume 13 Supplement 3, 2013: The Lives Saved Tool in 2013: new capabilities and applications. The full contents of the supplement are available online at http://www.biomedcentral.com/bmcpublichealth/supplements/13/S3.
PY - 2013
Y1 - 2013
N2 - Background: Short and long birth intervals have previously been linked to adverse neonatal outcomes. However, much of the existing literature uses cross-sectional studies, from which deriving causal inference is complex. We examine the association between short/long birth intervals and adverse neonatal outcomes by calculating and meta-analyzing associations using original data from cohort studies conducted in low-and middle-income countries (LMIC). Methods. We identified five cohort studies. Adjusted odds ratios (aOR) were calculated for each study, with birth interval as the exposure and small-for-gestational-age (SGA) and/or preterm birth, and neonatal and infant mortality as outcomes. The associations were controlled for potential confounders and meta-analyzed. Results: Birth interval of shorter than 18 months had statistically significant increased odds of SGA (pooled aOR: 1.51, 95% CI: 1.31-1.75), preterm (pooled aOR: 1.58, 95% CI: 1.19-2.10) and infant mortality (pooled aOR: 1.83, 95% CI: 1.19-2.81) after controlling for potential confounding factors (reference 36-<60 months). It was also significantly associated with term-SGA, preterm-appropriate-for-gestational-age, and preterm-SGA. Birth interval over 60 months had increased risk of SGA (pooled aOR: 1.22, 95% CI: 1.07-1.39) and term-SGA (pooled aOR: 1.14, 95% CI: 1.03-1.27), but was not associated with other outcomes. Conclusions: Birth intervals shorter than 18 months are significantly associated with SGA, preterm birth and death in the first year of life. Lack of access to family planning interventions thus contributes to the burden of adverse birth outcomes and infant mortality in LMICs. Programs and policies must assess ways to provide equitable access to reproductive health interventions to mothers before or soon after delivering a child, but also address underlying socioeconomic factors that may modify and worsen the effect of short intervals.
AB - Background: Short and long birth intervals have previously been linked to adverse neonatal outcomes. However, much of the existing literature uses cross-sectional studies, from which deriving causal inference is complex. We examine the association between short/long birth intervals and adverse neonatal outcomes by calculating and meta-analyzing associations using original data from cohort studies conducted in low-and middle-income countries (LMIC). Methods. We identified five cohort studies. Adjusted odds ratios (aOR) were calculated for each study, with birth interval as the exposure and small-for-gestational-age (SGA) and/or preterm birth, and neonatal and infant mortality as outcomes. The associations were controlled for potential confounders and meta-analyzed. Results: Birth interval of shorter than 18 months had statistically significant increased odds of SGA (pooled aOR: 1.51, 95% CI: 1.31-1.75), preterm (pooled aOR: 1.58, 95% CI: 1.19-2.10) and infant mortality (pooled aOR: 1.83, 95% CI: 1.19-2.81) after controlling for potential confounding factors (reference 36-<60 months). It was also significantly associated with term-SGA, preterm-appropriate-for-gestational-age, and preterm-SGA. Birth interval over 60 months had increased risk of SGA (pooled aOR: 1.22, 95% CI: 1.07-1.39) and term-SGA (pooled aOR: 1.14, 95% CI: 1.03-1.27), but was not associated with other outcomes. Conclusions: Birth intervals shorter than 18 months are significantly associated with SGA, preterm birth and death in the first year of life. Lack of access to family planning interventions thus contributes to the burden of adverse birth outcomes and infant mortality in LMICs. Programs and policies must assess ways to provide equitable access to reproductive health interventions to mothers before or soon after delivering a child, but also address underlying socioeconomic factors that may modify and worsen the effect of short intervals.
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U2 - 10.1186/1471-2458-13-S3-S3
DO - 10.1186/1471-2458-13-S3-S3
M3 - Review article
C2 - 24564484
AN - SCOPUS:84884370914
SN - 1471-2458
VL - 13
JO - BMC public health
JF - BMC public health
IS - SUPPL.3
M1 - S3
ER -