Assessing the Relationship between Short Birth-to-Pregnancy Interval and the Maternal and Perinatal Outcomes among Multiparous Women in Northern Ghana

Authors

  • Gilbert G. Agulu Ghana Health Service, Regional Health Directorate Private Mail Bag Bolgatanga, Upper East Region (UER), Ghana
  • Emmanuel K. Dzotsi Ghana Health Service, Regional Health Directorate Private Mail Bag Bolgatanga, UER, Ghana
  • Kofi Issah Family Health Division, Headquarters. Ghana Health Service, Greater Accra, Ghana
  • Josephat A. Nyuzaghl Ghana Health Service, Regional Health Directorate Private Mail Bag Bolgatanga, UER, Ghana
  • Alemna D. Adogboba Ghana Health Service, Regional Health Directorate Private Mail Bag Bolgatanga, UER, Ghana
  • Vincent A. Adongo Ghana Health Service, Regional Health Directorate Private Mail Bag Bolgatanga, UER, Ghana

Keywords:

Birth-to-pregnancy interval, hemorrhage, maternal, multiparous, perinatal, postpartum, puerperal

Abstract

Introduction: The World Health Organization (WHO) recommends an optimal Birth-to-Pregnancy Interval (BPI) of 24-59 months, or a 33- month interval between two successive births to reduce the risk of untoward maternal and newborn outcomes. Short Birth to Pregnancy Interval (SBPI), and unmet need for Family Planning (FP) are the major contributors to rapid population growth and increased maternal and newborn mortalities. The purpose of this study was to assess the adverse perinatal and maternal outcomes associated with SBPI among multiparous women in three municipalities of the Upper East Region (UER) of Ghana. Materials and Methods:The study employed the Cross-sectional Design conducted among 904 women aged 15-49 years attending Antenatal Care (ANC) clinics in three municipalities in the UER who had at least two successive live births prior to data collection. Data was collected using structured questionnaire, incorporated into the electronic data collection tool, Kobo collect and administered by trained research assistants. Birth interval was categorized according to the WHO’s classification, <24 months as SBPI, 24-≥59 months as Optimal Birth to Pregnancy Interval (OBPI) and >59 months as Long Birth to Pregnancy Interval (LBPI). Results: Of the 904 respondents, the majority (56.2%) had an OBPI, while 36.9% had a SBPI. Factors that influenced SBPI were parity, mode of delivery, and the educational status of women’s partner. Participants with a higher parity (≥5 children) had 0.67 times the potential of spacing their births (AOR 0.67; 95% CI 0.46-0.98; p = 0.040). Women who experienced a Caesarean Section (CS) delivery were 3.28 times more likely to have LBPI (AOR 3.28; 95% CI 1.02-10.62; p=0.047). Respondents whose partners had secondary education had a 1.87 chance (AOR 2.07; 95% CI 1.09-3.96; p=0.027) of spacing their births. The birth complications reported were retained products of conception (41.9%), pregnancy-induced hypertension (27.9%), postpartum hemorrhage (11.6%), obstructed labor (10.5%), sepsis (38.1%), neonatal jaundice (23.8%), lowbirth-weight (19%), and preterm birth (14.3%). Conclusion and Global Health Implications: The study recommends health professionals in direct contact with maternal, reproductive, and child health to be proactive in FP counseling, and to support women decision making. 

References

Ajayi, A. I., & Somefun, O. D. (2020). Patterns and determinants of short and long birth intervals among women in selected sub-Saharan African countries. Medicine, 99(19), e20118. https://doi.org/10.1097/MD.0000000000020118

Alhassan, A. R., Anyinzaam-Adolipore, J. N., & Abdulai, K. (2022). Short birth interval in Ghana: Maternal socioeconomic predictors and child survival. Population Medicine, 4(January), 1–8. https://doi.org/10.18332/POPMED/145914

Ayane, G. B., Desta, K. W., Demissie, B. W., Assefa, N. A., & Woldemariam, E. B. (2019). Suboptimal child spacing practice and its associated factors among women of child bearing age in Serbo town, JIMMA zone, Southwest Ethiopia. Contraception and Reproductive Medicine, 4(1), 1–8. https://doi.org/10.1186/s40834-019-0085-1

Bauserman, M., Nowak, K., Nolen, T. L., Patterson, J., Lokangaka, A., Tshefu, A., Patel, A. B., Hibberd, P. L., Garces, A. L., Figueroa, L., Krebs, N. F., Esamai, F., Liechty, E. A., Carlo, W. A., Chomba, E., Mwenechanya, M., Goudar, S. S., Ramadurg, U., Derman, R. J., … Bose, C. (2020). The relationship between birth intervals and adverse maternal and neonatal outcomes in six low and lower-middle income countries. Reproductive Health, 17(Suppl 2), 1–10. https://doi.org/10.1186/s12978-020-01008-4

Belachew, T. B., Asmamaw, D. B., & Negash, W. D. (2023). Short birth interval and its predictors among reproductive age women in high fertility countries in sub-Saharan Africa: a multilevel analysis of recent Demographic and Health Surveys. BMC Pregnancy and Childbirth, 23(1), 1–9. https://doi.org/10.1186/s12884-023-05403-0

Byamukama, O., Migisha, R., Kalyebara, P. K., Tibaijuka, L., Lugobe, H. M., Ngonzi, J., Ahabwe, O. M., Garcia, K. R. M., Mugyenyi, G. R., Boatin, A. A., Muhumuza, J., Ssalongo, W. G. M., Kayondo, M., & Kanyesigye, H. (2022). Short interbirth interval and associated factors among women with antecedent cesarean deliveries at a tertiary hospital, Southwestern Uganda. BMC Pregnancy and Childbirth, 22(1), 1–8. https://doi.org/10.1186/s12884-022-04611-4

Conde-Agudelo, A., Rosas-Bermudez, A., & Norton, M. H. (2016). Birth spacing and risk of autism and other neurodevelopmental disabilities: A systematic review. Pediatrics, 137(5). https://doi.org/10.1542/peds.2015-3482

Damtie, Y., Kefale, B., Yalew, M., Arefaynie, M., & Adane, B. (2021). Short birth spacing and its association with maternal educational status, contraceptive use, and duration of breastfeeding in Ethiopia. A systematic review and metaanalysis. PLoS ONE, 16(2 February), 1–15. https://doi.org/10.1371/journal.pone.0246348

David, H. C., Amani, M. N.-J., & Nancy, E. A. (2017). 乳鼠心肌提 取 HHS Public Access. Physiology & Behavior, 176(3), 139–148. https://doi.org/10.1038/s41372-019-0402-1.Short

Dehesh, T., Salarpour, E., Malekmohammadi, N., & Kermani, S. A. (2020). Associated factors of pregnancy spacing among women of reproductive age Group in South of Iran: Cross-sectional study. BMC Pregnancy and Childbirth, 20(1), 1–7. https://doi.org/10.1186/s12884-020-03250-x

Guure, C., Maya, E. T., Dery, S., Da-Costa Vrom, B., Alotaibi, R. M., Rezk, H. R., & Yawson, A. (2019). Factors influencing unmet need for family planning among Ghanaian married/union women: A multinomial mixed effects logistic regression modelling approach. Archives of Public Health, 77(1), 1–12. https://doi.org/10.1186/s13690-019-0340-6

Hailu, D., & Gulte, T. (2016). Determinants of Short Interbirth Interval among Reproductive Age Mothers in Arba Minch District, Ethiopia. International Journal of Reproductive Medicine, 2016, 1– 17. https://doi.org/10.1155/2016/6072437

Huber, L. R. B., Smith, K., Sha, W., & Vick, T. (2020). Interbirth Interval and Pregnancy Complications and Outcomes : Findings from the Pregnancy Risk Assessment Monitoring System. 1–10. https://doi.org/10.1111/jmwh.12745

Hutcheon, J. A., Nelson, H. D., Stidd, R., Moskosky, S., & Ahrens, K. A. (2019). Short interpregnancy intervals and adverse maternal outcomes in high-resource settings: An updated systematic review. Paediatric and Perinatal Epidemiology, 33(1), O48–O59. https://doi.org/10.1111/ppe.12518

Mehra, R., Keene, D. E., Kershaw, T. S., Ickovics, J. R., & Warren, J. L. (2019). Racial and ethnic disparities in adverse birth outcomes: Differences by racial residential segregation. SSM - Population Health, 8(January), 2–11. https://doi.org/10.1016/j.ssmph.2019.100417

Merdad, L., & Ali, M. M. (2018). Timing of maternal death : Levels , trends , and ecological correlates using sibling data from 34 subSaharan African countries. 5, 1–13.

Merklinger-Gruchala, A., Jasienska, G., & Kapiszewska, M. (2015). Short interpregnancy interval and low birth weight: A role of parity. American Journal of Human Biology, 27(5), 660–666. https://doi.org/10.1002/ajhb.22708

Molitoris, J. (2018). Heterogeneous Effects of Birth Spacing on Neonatal Mortality Risks in Bangladesh. Studies in Family Planning, 49(1), 3–21. https://doi.org/10.1111/sifp.12048

Nausheen, S., Bhura, M., Hackett, K., Hussain, I., Shaikh, Z., Rizvi, A., Ansari, U., Canning, D., Shah, I., & Soofi, S. (2021). Determinants of short birth intervals among married women: A crosssectional study in Karachi, Pakistan. BMJ Open, 11(4), 1–10. https://doi.org/10.1136/bmjopen-2020-043786

Pimentel, J., Ansari, U., Omer, K., Gidado, Y., Baba, M. C., Andersson, N., & Cockcroft, A. (2020). Factors associated with short birth interval in low- And middle-income countries: A systematic review. BMC Pregnancy and Childbirth, 20(1), 1–17. https://doi.org/10.1186/s12884-020-2852-z

Rao, J., Fan, D., Ma, H., Lin, D., Zhang, H., Zhou, Z., Li, P., Chen, G., Lu, D., Liu, Y., Wu, Z., He, J., Liu, X., Peng, B. J., Guo, X., & Liu, Z. (2022). Is there an optimal inter-delivery interval in women who underwent trial of labor after cesarean delivery (TOLAC)? Reproductive Health, 19(1), 1–7. https://doi.org/10.1186/s12978-021- 01319-0

Schummers, L., Hutcheon, J. A., Hernandez-Diaz, S., Williams, P. L., Hacker, M. R., Vanderweele, T. J., & Norman, W. V. (2018). Association of Short Interpregnancy Interval with Pregnancy Outcomes According to Maternal Age. JAMA Internal Medicine, 178(12), 1661–1670. https://doi.org/10.1001/jamainternmed.2018.4696

Shen, D. (2019). Munich Personal RePEc Archive Better Educated , Fewer Divorces : The Impact of College Education Quality on Marriage Outcomes Better Educated , Fewer Divorces : The Impact of College Education Quality on Marriage Outcomes. 94198.

Stover, J., & Winfrey, W. (2017). The effects of family planning and other factors on fertility, abortion, miscarriage, and stillbirths in the Spectrum model. BMC Public Health, 17(Suppl 4). https://doi.org/10.1186/s12889-017-4740-7

Survey, M. H., & Indicators, K. (2012). Key Indicators. Timing Solutions for Swing Traders, 91–111. https://doi.org/10.1002/9781119199045.ch6

Tesema, G. A., Worku, M. G., & Teshale, A. B. (2021). Duration of birth interval and its predictors among reproductive-age women in Ethiopia: Gompertz gamma shared frailty modeling. PLoS ONE, 16(2 February 2021), 1–13. https://doi.org/10.1371/journal.pone.0247091

Tessema, Z. T., Yazachew, L., Tesema, G. A., & Teshale, A. B. (2020). Determinants of postnatal care utilization in sub-Saharan Africa: a meta and multilevel analysis of data from 36 sub-Saharan countries. Italian Journal of Pediatrics, 46(1), 1–11. https://doi.org/10.1186/s13052-020-00944-y

Xu, T., Miao, H., Chen, Y., Luo, L., Guo, P., & Zhu, Y. (2022). Association of Interpregnancy Interval With Adverse Birth Outcomes. JAMA Network Open, 5(6), E2216658. https://doi.org/10.1001/jamanetworkopen.2022.16658

Yussuf, M. H., Elewonibi, B. R., Rwabilimbo, M. M., Mboya, I. B., & Mahande1, M. J. (2020). Trends and predictors of changes in modern contraceptive use among women aged 15-49 years in Tanzania from 2004-2016: Evidence from Tanzania Demographic and Health Surveys. PLoS ONE, 15(6 June), 1–14. https://doi.org/10.1371/journal.pone.0234980

Zimmerman, L. A., Yi, Y., Yihdego, M., Abrha, S., Shiferaw, S., Seme, A., & Ahmed, S. (2019). Effect of integrating maternal health services and family planning services on postpartum family planning behavior in Ethiopia: Results from a longitudinal survey. BMC Public Health, 19(1), 1–9. https://doi.org/10.1186/s12889-019-7703-3

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Published

2024-01-13

How to Cite

Agulu, G. G., Dzotsi, E. K., Issah, K., Nyuzaghl, J. A., Adogboba, A. D., & Adongo, V. A. (2024). Assessing the Relationship between Short Birth-to-Pregnancy Interval and the Maternal and Perinatal Outcomes among Multiparous Women in Northern Ghana. ESI Preprints, 25, 242. Retrieved from https://esipreprints.org/index.php/esipreprints/article/view/754

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