Factors associated with short birth interval in low- and middle-income countries: a systematic review

Abstract

Background: There is ample evidence of associations between short birth interval and adverse maternal and child health outcomes, including infant and maternal mortality. Short birth interval is more common among women in low-and middle-income countries. Identifying actionable aspects of short birth interval is necessary to address the problem. To our knowledge, this is the first systematic review to systematize evidence on risk factors for short birth interval in low-and middle-income countries. Methods: A systematic mixed studies review searched PubMed, Embase, LILACS, and Popline databases for empirical studies on the topic. We included documents in English, Spanish, French, Italian, and Portuguese, without date restriction. Two independent reviewers screened the articles and extracted the data. We used the Mixed Methods Appraisal Tool to conduct a quality appraisal of the included studies. To accommodate variable definition of factors and outcomes, we present only a narrative synthesis of the findings. Results: Forty-three of an initial 2802 documents met inclusion criteria, 30 of them observational studies and 14 published after 2010. Twenty-one studies came from Africa, 18 from Asia, and four from Latin America. Thirty-two reported quantitative studies (16 studies reported odds ratio or relative risk, 16 studies reported hazard ratio), 10 qualitative studies, and one a mixed-methods study. Studies most commonly explored education and age of the mother, previous pregnancy outcome, breastfeeding, contraception, socioeconomic level, parity, and sex of the preceding child. For most factors, studies reported both positive and negative associations with short birth interval. Shorter breastfeeding and female sex of the previous child were the only factors consistently associated with short birth interval. The quantitative and qualitative studies reported largely non-overlapping results.

Cloroquina y sus derivados en el manejo de la COVID-19: una revisión sistemática exploratoria

“…Debido al poco tiempo de preparación y la urgencia de los resultados, la estrategia de búsqueda de la presente revisión no contó con la orientación de un bibliotecólogo. Sin embargo, nuestro equipo tiene experiencia en la elaboración de revisiones sistemáticas 31 - 36 . Solo se incluyeron tres bases de datos, pero cada una de ellas aporta un aspecto clave a la búsqueda: Embase está especializada en farmacología, PubMed es la base de datos médica más nutrida del mundo, y Lilacs es la base de datos latinoamericana más completa.…”

Duration of birth interval and its predictors among reproductive-age women in Ethiopia: Gompertz gamma shared frailty modeling

“…Studies on birth interval showed that household wealth status [ 15 ], residence [ 15 ], husband education [ 16 ], maternal education [ 17 , 18 ], contraceptive use [ 19 , 20 ], media exposure [ 21 ], women health care decision making autonomy [ 22 ], religion [ 23 , 24 ], maternal occupation [ 15 ], breastfeeding duration [ 23 ], parity [ 24 ], and maternal age [ 25 ] were significant predictors of birth interval.…”

Causes of short birth interval (kunika) in Bauchi State, Nigeria: systematizing local knowledge with fuzzy cognitive mapping

“…The causes of kunika identified by women and men in Bauchi communities differ from those reported to be associated with short birth interval in quantitative studies in low- and middle-income countries. In a recent systematic review [ 11 ] only two factors were consistently associated with short birth interval in quantitative studies: shorter duration of breastfeeding and female sex of the previous child. The factors most frequently examined in the reviewed studies included age of the mother, education of the mother, education of the father, and household socio-economic status.…”

“…A study in the south of Nigeria found that loss of traditional healthcare practices was associated with more western education [ 40 ]. However, most studies examining maternal education and birth interval have found shorter birth interval associated with less maternal education [ 11 ]. The mapping groups in Bauchi talked openly about the use of aphrodisiacs and pornography as causes of frequent sex and hence kunika .…”

“…A recent systematic review examined the quantitative and qualitative evidence about factors related to short birth interval. For most factors, the evidence from quantitative studies was mixed; only shorter duration of breastfeeding and a female previous child were consistently associated with short birth interval [ 11 ]. Qualitative studies included in the review explored a broader range of factors including communication between couples and families, local media and social influence, and observation of other parents [ 11 ].…”