Birth intervals and associated factors in multi-Para Women

Background and Birth spacing has become a main strategy within health promotion programs for mothers and their children during the past two recent decades in the Islamic Republic of Iran. The present study was aimed to determine the patterns and factors associated with birth intervals in Multi-Para women residing in Babol. We conducted a cross-sectional study with samples consisting of 500 Multi-Para women, who were referred to the hospital and the Health Center for delivery in Babol, Northern Iran, during 2007. The data was collected using a designed questionnaire, including birth intervals between index child and prior, demographic and fertility variables, such as maternal education, maternal age at birth of index child, sex before index child, still birth, child status before index child, parity, duration of breast feeding, residence area, contraception methods, and attending family planning clinic. The data was analyzed using the logistic regression model. The mean (SD) of birth intervals was 61±25.7 months. Birth interval in 3.8% of mothers was less than 2 years and 41.7% of mothers had 4 to 6 years, while 28% had ≥6 years. In the majority of women, (76.8%) pregnancies were from 20 to 34 years of age. In spite, pregnancy was observed in 22.4% cases in age 35 or over, while 0.8% of pregnancies were in the age range less than 20 years. Maternal age, duration of breast feeding, child sex before index child, still birth, history of infant mortality before index child, type of contraception, attending family planning clinics and parity showed a significant relation with birth intervals. Maternal age, parity, duration of breastfeeding, still birth, history of infant mortality, attending family planning clinics and using modern contraceptive methods are shown to be determinants of birth intervals. Although our findings indicated that in the majority of Multi-Para women, birth intervals was within the accepted range previously recommended by the Ministry of Health in Iran, over a quarter of women had birth intervals of ≥6 years. Due to increasing maternal age associated with high risk pregnancies (aged >35yeras) by long birth intervals, it is necessary to revise educational programs for prevention of long birth intervals, that would induce the subsequent pregnancies in becoming high risk.