Scaling-up access to family planning may improve linear growth and child development in low and middle income countries.
<h4>Background</h4>A large literature has indicated a robust association between birth spacing and child survival, but evidence on the association of birth timing with physical growth in low and middle income countries (LMICs) remains limited.<h4>Methods and results</h4>Data...
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2014-01-01
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| Online Access: | https://doi.org/10.1371/journal.pone.0102391 |
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| author | Günther Fink Christopher R Sudfeld Goodarz Danaei Majid Ezzati Wafaie W Fawzi |
| author_facet | Günther Fink Christopher R Sudfeld Goodarz Danaei Majid Ezzati Wafaie W Fawzi |
| author_sort | Günther Fink |
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| description | <h4>Background</h4>A large literature has indicated a robust association between birth spacing and child survival, but evidence on the association of birth timing with physical growth in low and middle income countries (LMICs) remains limited.<h4>Methods and results</h4>Data from 153 cross-sectional Demographic and Health Surveys (DHS) across 61 LMICs conducted between 1990 and 2011 were combined to assess the association of birth timing with child stunting (height-for-age z-score <-2). A total of 623,789 children of birth order 1-5 contributed to the maternal age analysis, while the birth spacing dataset consisted of 584,226 children of birth order 2 and higher. Compared to 27-34 year old mothers, maternal age under 18 years was associated with a relative stunting risk of 1.35 (95% CI: 1.29-1.40) for firstborn children, whereas the relative risk was 1.24 (95% CI: 1.19-1.29) for mothers aged 18-19 years. The association of young maternal age with stunting was significantly greater for urban residents and those in the top 50% of household wealth. Birth intervals less than 12 months and 12-23 months had relative risks for stunting of 1.09 (95% CI: 1.06-1.12) and 1.06 (95% CI: 1.05-1.06) as compared to a 24-35 month inter-pregnancy interval, respectively. The strength of both teenage pregnancy and short birth interval associations showed substantial variation across WHO region. We estimate that 8.6% (6.9-10.3%) of stunted cases in the South Asian DHS sample would have been averted by jointly eliminating teen pregnancies and birth intervals less than 24 months, while only 3.6% (1.5-5.7%) of stunting cases would have prevented in the Middle East and North Africa sample.<h4>Conclusions</h4>Postponing the age of first birth and increasing inter-pregnancy intervals has the potential to significantly reduce the prevalence of stunting and improve child development in LMICs. |
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| id | doaj-art-7e2042fcbb7f47f1b9b613296e352f74 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-7e2042fcbb7f47f1b9b613296e352f742025-08-20T03:46:23ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0197e10239110.1371/journal.pone.0102391Scaling-up access to family planning may improve linear growth and child development in low and middle income countries.Günther FinkChristopher R SudfeldGoodarz DanaeiMajid EzzatiWafaie W Fawzi<h4>Background</h4>A large literature has indicated a robust association between birth spacing and child survival, but evidence on the association of birth timing with physical growth in low and middle income countries (LMICs) remains limited.<h4>Methods and results</h4>Data from 153 cross-sectional Demographic and Health Surveys (DHS) across 61 LMICs conducted between 1990 and 2011 were combined to assess the association of birth timing with child stunting (height-for-age z-score <-2). A total of 623,789 children of birth order 1-5 contributed to the maternal age analysis, while the birth spacing dataset consisted of 584,226 children of birth order 2 and higher. Compared to 27-34 year old mothers, maternal age under 18 years was associated with a relative stunting risk of 1.35 (95% CI: 1.29-1.40) for firstborn children, whereas the relative risk was 1.24 (95% CI: 1.19-1.29) for mothers aged 18-19 years. The association of young maternal age with stunting was significantly greater for urban residents and those in the top 50% of household wealth. Birth intervals less than 12 months and 12-23 months had relative risks for stunting of 1.09 (95% CI: 1.06-1.12) and 1.06 (95% CI: 1.05-1.06) as compared to a 24-35 month inter-pregnancy interval, respectively. The strength of both teenage pregnancy and short birth interval associations showed substantial variation across WHO region. We estimate that 8.6% (6.9-10.3%) of stunted cases in the South Asian DHS sample would have been averted by jointly eliminating teen pregnancies and birth intervals less than 24 months, while only 3.6% (1.5-5.7%) of stunting cases would have prevented in the Middle East and North Africa sample.<h4>Conclusions</h4>Postponing the age of first birth and increasing inter-pregnancy intervals has the potential to significantly reduce the prevalence of stunting and improve child development in LMICs.https://doi.org/10.1371/journal.pone.0102391 |
| spellingShingle | Günther Fink Christopher R Sudfeld Goodarz Danaei Majid Ezzati Wafaie W Fawzi Scaling-up access to family planning may improve linear growth and child development in low and middle income countries. PLoS ONE |
| title | Scaling-up access to family planning may improve linear growth and child development in low and middle income countries. |
| title_full | Scaling-up access to family planning may improve linear growth and child development in low and middle income countries. |
| title_fullStr | Scaling-up access to family planning may improve linear growth and child development in low and middle income countries. |
| title_full_unstemmed | Scaling-up access to family planning may improve linear growth and child development in low and middle income countries. |
| title_short | Scaling-up access to family planning may improve linear growth and child development in low and middle income countries. |
| title_sort | scaling up access to family planning may improve linear growth and child development in low and middle income countries |
| url | https://doi.org/10.1371/journal.pone.0102391 |
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