“…The rising rates with length of IPI of pre‐eclampsia, the second most common cause of maternal mortality worldwide,16 underscores the importance of the persistence needed for improving coverage of obstetric care. The finding that maternal mortality is not linked with the length of IPI emphasises the role of family planning and breastfeeding in promoting safe motherhood and achieving better offspring outcomes 17, 18…”
ObjectiveTo determine the relationship of interpregnancy interval with maternal and offspring outcomes.DesignRetrospective study with data from the Perinatal Information System database of the Latin American Centre for Perinatology and Human Development, Uruguay.SettingLatin America, 1990–2009.PopulationA cohort of 894 476 women delivering singleton infants.MethodsDuring 1990–2009 the Perinatal Information System database of the Latin American Centre for Perinatology identified 894 476 women with defined interpregnancy intervals: i.e. the time elapsed between the date of the previous delivery and the first day of the last normal menstrual period for the index pregnancy. Using the interval 12–23 months as the reference category, multiple logistic regression estimated adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) of the association between various interval lengths and maternal and offspring outcomes.Main outcome measuresMaternal death, pre‐eclampsia, eclampsia, puerperal infection, fetal death, neonatal death, preterm birth, and low birthweight.ResultsIn the reference interval there was 0.05% maternal death, 1.00% postpartum haemorrhage, 2.80% pre‐eclampsia, 0.15% eclampsia, 0.28% puerperal infection, 3.45% fetal death, 0.68% neonatal death, 12.33% preterm birth, and 9.73% low birthweight. Longer intervals had increased odds of pre‐eclampsia (>72 months), fetal death (>108–119 months), and low birthweight (96–107 months). Short intervals of <12 months had increased odds of pre‐eclampsia (aOR 0.80; 95% CI 0.76–0.85), neonatal death (aOR 1.18; 95% CI 1.08–1.28), and preterm birth (aOR 1.16; 95% CI 1.11–1.21). Statistically, the interval had no relationship with maternal death, eclampsia, and puerperal infection.ConclusionsA short interpregnancy interval of <12 months is associated with pre‐eclampsia, neonatal mortality, and preterm birth, but not with other maternal or offspring outcomes. Longer intervals of >72 months are associated with pre‐eclampsia, fetal death, and low birthweight, but not with other maternal or offspring outcomes.Tweetable abstractA short interpregnancy interval of <12 months is associated with neonatal mortality and preterm birth.
“…The rising rates with length of IPI of pre‐eclampsia, the second most common cause of maternal mortality worldwide,16 underscores the importance of the persistence needed for improving coverage of obstetric care. The finding that maternal mortality is not linked with the length of IPI emphasises the role of family planning and breastfeeding in promoting safe motherhood and achieving better offspring outcomes 17, 18…”
ObjectiveTo determine the relationship of interpregnancy interval with maternal and offspring outcomes.DesignRetrospective study with data from the Perinatal Information System database of the Latin American Centre for Perinatology and Human Development, Uruguay.SettingLatin America, 1990–2009.PopulationA cohort of 894 476 women delivering singleton infants.MethodsDuring 1990–2009 the Perinatal Information System database of the Latin American Centre for Perinatology identified 894 476 women with defined interpregnancy intervals: i.e. the time elapsed between the date of the previous delivery and the first day of the last normal menstrual period for the index pregnancy. Using the interval 12–23 months as the reference category, multiple logistic regression estimated adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) of the association between various interval lengths and maternal and offspring outcomes.Main outcome measuresMaternal death, pre‐eclampsia, eclampsia, puerperal infection, fetal death, neonatal death, preterm birth, and low birthweight.ResultsIn the reference interval there was 0.05% maternal death, 1.00% postpartum haemorrhage, 2.80% pre‐eclampsia, 0.15% eclampsia, 0.28% puerperal infection, 3.45% fetal death, 0.68% neonatal death, 12.33% preterm birth, and 9.73% low birthweight. Longer intervals had increased odds of pre‐eclampsia (>72 months), fetal death (>108–119 months), and low birthweight (96–107 months). Short intervals of <12 months had increased odds of pre‐eclampsia (aOR 0.80; 95% CI 0.76–0.85), neonatal death (aOR 1.18; 95% CI 1.08–1.28), and preterm birth (aOR 1.16; 95% CI 1.11–1.21). Statistically, the interval had no relationship with maternal death, eclampsia, and puerperal infection.ConclusionsA short interpregnancy interval of <12 months is associated with pre‐eclampsia, neonatal mortality, and preterm birth, but not with other maternal or offspring outcomes. Longer intervals of >72 months are associated with pre‐eclampsia, fetal death, and low birthweight, but not with other maternal or offspring outcomes.Tweetable abstractA short interpregnancy interval of <12 months is associated with neonatal mortality and preterm birth.
“…In a 2012 study, contraceptive use is responsible for a predicted 44% reduction in maternal mortality globally [23]. By decreasing the likelihood of unplanned pregnancies, an increase in contraception use could result in a reduction of women presenting for PNC late and, therefore, lead to improved maternal and infant outcomes.…”
Synopsis: Current barriers to early prenatal care in South Africa include poor pregnancy planning, fear of HIV-related stigma, and cultural perceptions and superstitions.
ABSTRACTObjective: To understand the barriers delaying early prenatal care for women in South Africa.Methods: A mixed-methods study was conducted at a center in Pretoria. Conclusion: Significant efforts should be devoted to improving access to contraception and prepregnancy counseling in order to improve early prenatal care attendance.
ResultsSimilarly, addressing cultural concerns and fears regarding pregnancy is imperative in promoting early attendance.
“…In the East Asian context, this dividend has accounted for 10–20% of economic growth [13,21]. Lower rates of childbearing also imply greater opportunities for mothers’ education [2] and employment as well as better health for mothers and children due to broader spacing between children [3–5,22]. …”
Section: Discussionmentioning
confidence: 99%
“…Such goals provide important nodes for international cooperation. And in the arena of public health, family planning provides numerous benefits, such as the reduction of maternal and child mortality [3–5] as well as the prevention of HIV transmission [6]. 10.1080/16549716.2018.1423861-F0001Figure 1.Total fertility rate in 2030: Reference and 75% benchmark projections.…”
Background: Meeting demand for family planning can facilitate progress towards all major themes of the United Nations Sustainable Development Goals (SDGs): people, planet, prosperity, peace, and partnership. Many policymakers have embraced a benchmark goal that at least 75% of the demand for family planning in all countries be satisfied with modern contraceptive methods by the year 2030.
Objective: This study examines the demographic impact (and development implications) of achieving the 75% benchmark in 13 developing countries that are expected to be the furthest from achieving that benchmark.
Methods: Estimation of the demographic impact of achieving the 75% benchmark requires three steps in each country: 1) translate contraceptive prevalence assumptions (with and without intervention) into future fertility levels based on biometric models, 2) incorporate each pair of fertility assumptions into separate population projections, and 3) compare the demographic differences between the two population projections. Data are drawn from the United Nations, the US Census Bureau, and Demographic and Health Surveys.
Results: The demographic impact of meeting the 75% benchmark is examined via projected differences in fertility rates (average expected births per woman’s reproductive lifetime), total population, growth rates, age structure, and youth dependency. On average, meeting the benchmark would imply a 16 percentage point increase in modern contraceptive prevalence by 2030 and a 20% decline in youth dependency, which portends a potential demographic dividend to spur economic growth.
Conclusions: Improvements in meeting the demand for family planning with modern contraceptive methods can bring substantial benefits to developing countries. To our knowledge, this is the first study to show formally how such improvements can alter population size and age structure. Declines in youth dependency portend a demographic dividend, an added bonus to the already well-known benefits of meeting existing demands for family planning.
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