Mothers in an Urban Township in Zambia

Two hundred and forty-nine mothers living in an urban township were followed at their home from delivery for 1 year. Sixty-four families were lost to follow up due to moving house. The neonatal mortality was 50.6 per thousand and the infant mortality 118 per thousand live births. Child loss increased after parity 8 of the mother. The mean (SD) weight of mothers was 56.8 kg (8.8), the mean height 157.8 cm (6.1) and the mean ponderal index 22.53 (3.51). The mid-arm circumference was 26.1 cm (2.8). Body size varied considerably with around 10 per cent of mothers being undernourished and 10 per cent obese. Weight and mid-arm circumference generally decreased after 6 months post-partum. Breast feeding became less frequent after 8 months and by a year four babies had stopped receiving any breast milk. Average birth intervals were around 30 months, but thirty-seven mothers (20 per cent of multiparous mothers) had intervals of less than two years often following the loss of a previous child. Women generally received less education than their husbands with 35 (17 per cent) having had no education and only 23 (11 per cent) with some secondary education. Thirty-five mothers (18 per cent) had no men living at home with them although some fathers provided support. By one year fifteen fathers had abandoned the mother. Incomes of most families were insufficient and half the mothers worked, usually by selling food at the market or outside their homes.(ABSTRACT TRUNCATED AT 250 WORDS)     

Antenatal iron–folic acid supplementation reduces risk of low birthweight in Pakistan: secondary analysis of Demographic and Health Survey 2006–2007

The aim of the current study was to examine the impact of antenatal iron–folic acid (IFA) supplementation on perceived birth size and birthweight in Pakistan over a 5‐year period from 2002 to 2006. The data source was the Pakistan Demographic and Health Survey (PDHS) 2006–2007. Information from 5692 most recent live‐born infants within 5 years prior to the survey was examined. The primary outcomes were maternal perception of birth size and birthweight, and the main exposure was any use of antenatal IFA supplements. Birthweight was reported for only 10% of the live births in the PDHS 2006–2007. Multivariate logistic regression analysis was adjusted for the cluster sampling design and for 13 potential confounders. The risk of having smaller than average birth size newborn was significantly reduced by 18% (adjusted odds ratio 0.82, 95% confidence interval 0.71, 0.96) for mothers who used any IFA supplements compared with those who did not. A similar (18%), but non‐significant reduction in the risk of low birthweight, was found with the maternal use of IFA supplements. The risk of having smaller than average birth size babies was significantly reduced by 19% in those women who started IFA in the first trimester of pregnancy. About 11% of babies with smaller than average birth size were attributed to non‐use of antenatal IFA supplements. Antenatal IFA supplementation significantly reduces the risk of a newborn of smaller than average birth size in Pakistan. Universal coverage of supplementation would improve birth size.     

CONGENITAL DISLOCATION OF THE HIP IN NORWAY Late Diagnosis CDH in the Years 1970 to 1974

ABSTRACT. A survey of 274 late detected cases of CDH born in the years 1970–74 is presented. The incidence of late cases in southeast Norway was calculated to 2.2 per 1000 live births. The hips of all patients were examined at birth, the majority by trained pediatricians, without disclosing any hip affections. 86% were females. Only 6.9% were delivered in the breech position. One–half of the patients had luxation (20%) or subluxation (30%), the rest had dysplasia without dislocation. In 19% both hips were involved. The low incidence of breech presentations in late CDH-cases compared with the incidence among neonatal cases (15.7%) point to some etiological differences. It seems that we in Norway have two types of CDH, one caused by joint laxity and detectable at birth and another, not present at birth, with progressive dysplasia of the hip and dislocation developing during the first year of life.     

Congenital dislocation of the hip in Norway. Late diagnosis CDH in the years 1970 to 1974

A survey of 274 late detected cases of CDH born in the years 1970--74 is presented. The incidence of late cases in southeast Norway was calculated to 2.2 per 1 000 live births. The hips of all patients were examined at birth, the majority by trained pediatricians, without disclosing any hip affections. 86% were females. Only 6.9% were delivered in the breech position. One-half of the patients had luxation (20%) or subluxation (30%), the rest had dysplasia without dislocation. In 19% both hips were involved. The low incidence of breech presentations in late CDH-cases compared with the incidence among neonatal cases (15.7%) point to some etiological differences. It seems that we in Norway have two types of CDH, one caused by joint laxity and detectable at birth and another, not present at birth, with progressive dysplasia of the hip and dislocation developing during the first year of life.     

Non-viable delivery at 20-23 weeks gestation: observations and signs of life after birth

OBJECTIVE: To describe the outcome of labour, signs of life at birth, and duration of survival after delivery at 20-23 weeks gestation. DESIGN: An observational study using data from the Confidential Enquiry into Stillbirths and Deaths in Infancy 1995-2000. SETTING: All deliveries to mothers resident in Trent Health Region. PATIENTS: 1306 babies delivered at 20-23 weeks gestation. RESULTS: Termination of pregnancy accounted for 33% of deliveries at 20-23 weeks; these were excluded from further analysis. Spontaneous delivery occurred at a frequency of 2.5/1000 deliveries; 30% died before the onset of labour, 27% died during labour, and 35% showed signs of life at birth. Of the latter, 8% were not registered as statutory live births. Of the live born infants, the largest group (39%) had a heart beat but no other signs of life. There was no trend for infants of lower gestation to show fewer signs of life. Duration of survival varied widely (median 60 minutes at 20-22 weeks), and this did not increase with gestation until 23 weeks (median six hours), probably because of selective treatment. Survival curves are presented for each gestation group. At 23 weeks, 4.5% survived to 1 year of age; all were > 500 g birth weight. Below 23 weeks gestation, none survived, and 94% had died within 4 hours of age. CONCLUSIONS: This information on surviving labour, signs of life at birth, duration of survival, and birth weight at 20-23 weeks gestation should help decision making in the management of pre-viable delivery.     

Trends in prevalence and survival of very low birthweight infants, England and Wales: 1983-7.

Between 1983 and 1987 over 99% of all infants born in England and Wales had their birth weights recorded when the birth was registered. Trends in occurrence and one year survival of those who weighed under 1500 g at birth have been calculated in 100 g groups, separately for single and multiple births. By 1987 singleton live births in England and Wales who weighed between 700 and 799 g had a 43% chance of surviving to 1 year compared with a 32% chance five years earlier; those who weighed 800 to 899 g had a 55% chance compared with 46%. The absolute number of survivors weighing between 500 and 999 g at birth increased by nearly 50% between 1983 and 1987, and there was a 30% increase overall in survivors weighing less than 1500 g.     

Breast milk feeding and cognitive ability at 7-8 years

OBJECTIVE: To examine the association between duration of breast milk feeding and cognitive ability at 7-8 years in a birth cohort of very low birthweight infants. DESIGN: 280 survivors from a national birth cohort of 413 New Zealand very low birthweight infants born in 1986 were assessed at age 7-8 years on measures of verbal and performance intelligence quotient (IQ) using the WISC-R. At the same time mothers were questioned as to whether they had elected to provide expressed breast milk at birth and the total duration of breast milk feeding. RESULTS: Some 73% of mothers provided expressed breast milk and 37% breast fed for four months or longer. Increasing duration of breast milk feeding was associated with increases in both verbal IQ (p < 0.001) and performance IQ (p < 0.05): children breast fed for eight months or longer had mean (SD) verbal IQ scores that were 10.2 (0.56) points higher and performance IQ scores that were 6.2 (0.35) points higher than children who did not receive breast milk. These differences were substantially reduced after control for selection factors associated with receipt of breast milk. Nevertheless, even after control for confounding, there remained a significant (p < 0.05) association between duration of breast milk feeding and verbal IQ: children breast fed for eight months or longer had adjusted mean (SD) verbal IQ scores that were 6 (0.36) points higher than the scores of those who did not receive breast milk. CONCLUSIONS: These findings add to a growing body of evidence to suggest that breast milk feeding may have small long term benefits for child cognitive development.     

Infant survival in Norway and Sweden 1985–88

In recent years, considerable attention has been attached to the disquieting fact that infant survival is much lower in Norway than in Sweden. In the present study, comprising all live single births in Norway and Sweden during 1985–88, the observed infant mortality was 1.5 times higher in Norway than in Sweden. The largest difference between Norway and Sweden was found in infants of young mothers with high birth order. Thus for the second births of mothers aged less than 20 years the observed mortality ratio of Norway to Sweden was 1.8. The infant mortality ratio decreased with increasing maternal age for all birth orders, and for the second births of mothers aged 35 years or more the mortality ratio was 1.0. The higher infant mortality in Norway was evident throughout the first year of life, with the highest mortality ratio observed at 6–8 months of life. Adjustment for maternal age, birth order and geographical region did not alter the observed infant mortality ratios. In both countries, the highest risk was found among infants of young mothers, This suggests a need for a more extensive preventive health care system directed at young mothers during their pregnancy and the infancy period.     

State reporting of live births of newborns weighing less than 500 grams: impact on neonatal mortality rates

The National Center for Health Statistics reports that in 1983 65% of all infant deaths in the United States occurred in the neonatal period. Of these reported neonatal deaths, 17% were of infants weighing less than 500 g at birth. There was, however, variation in state-reported incidence of live births of newborns in this weight cohort (0.2 to 2.2 per 1,000 live births). The states with the lowest neonatal mortality rate have the lowest incidence of birth weights less than 500 g (rho = .77). If it is assumed that mortality for this weight category is nearly 100%, there is marked variation (5% to 32%) in the contribution of this weight cohort to a state's total neonatal mortality rate. Contributing to this variation may be definitions of live birth used by states. The World Health Organization defines a live birth as the product of conception showing signs of life "irrespective of the duration of pregnancy" and this definition is used by 33 states. Only one state (Ohio) includes the gestational criteria of "at least 20 weeks" in its definition of live birth. There is evidence to suggest that definitions are not uniformly used within individual states. For example, in 1983, 20 states did not report any live births with weights less than 500 g among their "other" populations of nonwhite, nonblack residents. Half of these states, however, use the World Health Organization definition of live birth. Despite the exclusionary wording in Ohio's definition of liver birth, 16% of newborns who died in that state had birth weights less than 500 g.(ABSTRACT TRUNCATED AT 250 WORDS)     

Early neonatal streptococcal infection

Objective To determine the incidence of early onset Group B Streptococcal (GBS) infection in infants born over a two year period and to determine the outcome of sepsis evaluation in infants born to mothers with GBS colonization. Methods The charts of infants born to mothers with GBS colonization were reviewed for details of sepsis evaluation and management. The microbiology records were used to identify proven cases of GBS septicemia and meningitis in neonates born during the study period. Results Out of a total of 4636 live births in 2 years, there was one infant with culture-proven GBS septicemia, an incidence of 0.2 per 1000 live births. During the study period 83 infants were born to mothers who were known to have GBS carriage at the time of delivery. 73 out of these 83 infants (88%) had sepsis evaluation and received empirical parenteral penicillin for at least 5 days. There were no cases of blood culture-proven GBS sepsis among these 83 infants. However, there were 2 cases of probable sepsis giving an attack rate of 2.4%. All the three infants with definite or probable sepsis were preterm; there were no deaths among these affected infants. Conclusion The overall incidence of early onset GBS sepsis was found to be low when compared to previous reported studies. The strategy of sepsis evaluation and management was found to be effective in preventing death and definite GBS septicemia in infants born to GBS colonized mothers.     

Low birthweight in Hausa infants

As infants with low birth weights (LBWs) constitute a group in need of specialized care, the problems of LBW among the Hausas of Nigeria were evaluated. The case records of all liveborn infants of Hausa parents, born at the Maternity Hospital in Katsina, Nigeria between January 1, 1974 and December 31, 1977, were selected for study. The LBW infants i.e., those weighing 2500 g or below were separated, their characteristics studied, and possible etiological factors identified. A comparison of this group was then made with those neonates who weighed more than 2500 g. The duration of gestation was determined from the menstrual history and by appropriate clinical examination before delivery. As data were not considered to be very reliable, no attempt was made to correlate the birth weights with duration of pregnancy. Infants born before the 37th week of pregnancy were labeled as premature. During the study period, 3890 live Hausa infants (2111 males and 1779 females) were born to 3780 mothers. Of these 3890 infants, 408 males and 420 females weighed 2500 g or less. These 828 infants were born to 774 mothers and included 91 sets of twins and 5 sets of triplets though the outcome of all multiple pregnancies were not live births. The maternal age ranged from 13-45 years. The parity ranged from 0-14 but there were more primigravida compared to other parities. All mothers belonged to lower and middle socioeconomic classes. 70% were urban and 30% were rural. The incidence of LBW was 213/1000 live births or 21.3%. 71.1% of these babies weighed between 2000 g and 2500 g; only 1.6% weighed less than 1000 g. The percentage of females among LBW infants was higher (50.7%) as compared to that of males (49.3%). The incidence of LBW was 19.3% among males and 23.6% among females. The monthly and seasonal incidence of LBW was uniform and no seasonal variation could be found. The incidence of LBW was 18.4% among urban women and 23.4% among rural women. The difference was highly significant. The highest percentage of deaths in the present study occurred among infants weighing less than 1000 g and the immediate neonatal death rate declined in each successive higher weight group, exhibiting a strong relationship between LBW and immediate neonatal mortality. Only 1 child died out of 589 who weighed between 2001-2500 g.     

THE INFLUENCE OF PERINATAL FACTORS ON BREAST FEEDING

ABSTRACT. The effect on breast feeding of various factors connected with delivery and the immediate post partum period were investigated in a group of 1701 parturients. Children born by caesarean section or assisted delivery, those of low birth weight or asphyxiated at birth started breast feeding significantly less often than healthy children delivered normally. The length of breast feeding was not affected by these factors once it was started, 49% breast feeding for six months or more. Exceptionally young and old mothers breast fed less well than mothers in general. Mothers whose husbands attended the delivery breast fed more often and longer than others. Failure to start breast feeding occurred in only 2.4% of the material. In this material with high breast feeding rates it can be concluded that obstetric and perinatal abnormalities have a small but nevertheless significant effect on the incidence of breast feeding.     

Possible effects of emergency caesarian section on the mother-child relationship

This study was a pilot project to explore the mother-child relationship in a group of mothers delivered by emergency caesarian section and to compare them with a control group of mothers delivered by normal vaginal delivery. The mothers delivered by caesarian section had a period of amnesia after the birth so that their recollected first contact with their baby was later than the control group and at one month the mothers delivered by caesarian section had much less eye-to-eye contact with their baby.There were differences in attitudes and behaviour between the caesarian and control group of mothers'at one month and at one year. The mothers delivered by caesarian section had more doubts about their capacity to care for their babies, were more depressed with symptoms and felt their babies did not become a person until later.There were no differences between the two groups of children in general behaviour and development although the babies delivered by caesarian section were larger and this difference persisted through to one year. This ceasarian group of mothers found adjusting to the birth of their first baby and parenthood more difficult than the control group of mothers.     

Annual summary of vital statistics: 2005

The general fertility rate in 2005 was 66.7 births per 1000 women aged 15 to 44 years, the highest level since 1993. The birth rate for teen mothers (aged 15 to 19 years) declined by 2% between 2004 and 2005, falling to 40.4 births per 1000 women, the lowest ever recorded in the 65 years for which there are consistent data. The birth rates for women > or = 30 years of age rose in 2005 to levels not seen in almost 40 years. Childbearing by unmarried women also increased to historic record levels for the United States in 2005. The cesarean-delivery rate rose by 4% in 2005 to 30.2% of all births, another record high. The preterm birth rate continued to rise (to 12.7% in 2005), as did the rate for low birth weight births (8.2%). The infant mortality rate was 6.79 infant deaths per 1000 live births in 2004, not statistically different from the rate in 2003. Pronounced differences in infant mortality rates by race and Hispanic origin continue, with non-Hispanic black newborns more than twice as likely as non-Hispanic white and Hispanic infants to die within 1 year of birth. The expectation of life at birth reached a record high in 2004 of 77.8 years for all gender and race groups combined. Death rates in the United States continued to decline, with death rates decreasing for 9 of the 15 leading causes. The crude death rate for children aged 1 to 19 years did not decrease significantly between 2003 and 2004. Of the 10 leading causes of death for 2004 in this age group, only the rates for influenza and pneumonia showed a significant decrease. The death rates increased for intentional self-harm (suicide), whereas rates for other causes did not change significantly for children. A large proportion of childhood deaths continue to occur as a result of preventable injuries.     

Diabetes mellitus during pregnancy and the risks for specific birth defects: a population-based case-control study

Although the excess risk for birth defects among children of mothers with diabetes mellitus is well documented, there are few data concerning the risk for specific malformations. In the Atlanta Birth Defects Case-Control Study, those risks for malformations were evaluated. The population-based study included 4929 live and stillborn babies with major malformations ascertained by the Metropolitan Atlanta Congenital Defects Program in the first year of life born to residents of Metropolitan Atlanta between 1968 and 1980. The study also included 3029 nonmalformed live babies who were frequency-matched to case babies by race, period of birth, and hospital of birth. The relative risk for major malformations among infants of mothers with insulin-dependent diabetes mellitus (n = 28) was 7.9 (95% confidence interval [CI]1.9, 33.5) compared with infants of nondiabetic mothers. The relative risks for major central nervous system and cardiovascular system defects were 15.5 (95% CI = 3.3, 73.8) and 18.0 (95% CI = 3.9, 82.5), respectively. The absolute risks for major, central nervous system, and cardiovascular system malformations among infants of diabetic mothers were 18.4, 5.3, and 8.5 per 100 live births, respectively. Infants of mothers with gestational diabetes mellitus who required insulin during the third trimester of pregnancy were 20.6 (95% CI = 2.5, 168.5) times more likely to have major cardiovascular system defects than infants of nondiabetic mothers. The absolute risk for infants of this group of diabetic mothers was 9.7%. No statistically significant differences were found among infants of mothers with gestational diabetes mellitus who did not require insulin during pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)     

Perinatal demography of gastroschisis in North Queensland

Aim: To review the demography of gastroschisis in North Queensland. Methods: A retrospective chart review of live born cases of gastroschisis originating in North Queensland from 1988 to 2007. Results: Fifty‐nine cases were identified, giving an overall rate of 3.2 per 10 000 live births. In mothers <20 years old compared with 20–24 and 25–29 it was 12.1, 6.3 and 1.7. Overall, the rate was higher in Indigenous mothers (6.6 vs. 2.6, OR 2.5; 95% CI 1.4–4.5, P= 0.0018). Overall, the rate increased significantly from 0.7 per 10 000 live births in the first 5 years of the study to 4.8 in the last (trend test P= 0.0015), but it increased particularly in mothers <20 years old, from 2.40 in the first 5 years to 19.3 in the last (trend test P= 0.0177). It also rose from 0 to 3.6 in those aged 25–29 (P= 0.0337) but remained stable in other age groups. There was no difference in the outcomes of babies born to Indigenous or non‐Indigenous mothers, or in outcomes of babies delivered vaginally or by Caesarean section, or in outcomes of babies from any particular location in North Queensland. There was no significant difference in the average age of Indigenous and non‐Indigenous mothers. Conclusion: Gastroschisis is increasing in North Queensland, especially in mothers <20. Overall, the rate in Indigenous mothers is two to three times higher.     

Intergenerational breastfeeding practices among parents and children: 1993 Pelotas (Brazil) birth cohort

The objective of this study was to investigate intergenerational breastfeeding practices according to parental sex and age at delivery in the 1993 Pelotas (Brazil) birth cohort study. This is a prospective birth cohort study, and at the 22‐year follow‐up, a substudy with all children of the cohort members who had become parents was conducted (93Cohort‐II). First generation breastfeeding data were collected at 3 months and 4‐year‐old follow‐ups. In the 93Cohort‐II, parents answered a questionnaire about their children's breastfeeding practices. Adjusted Tobit and Poisson regression models with robust variance were applied to estimate the association between predominant parental breastfeeding duration and exclusive breastfeeding duration of the children at 3 and 6 months. Out of 3,810 cohort participants, 955 (25%) had delivered at least one live‐born infant, and 1,222 children were assessed. Fifty‐four percent of parents were ≤19 years old. Direct effects of predominant parental breastfeeding duration on exclusive breastfeeding duration of their children were only observed when data were stratified by parental age: children born to parents aged ≥20 years old and who were predominantly breastfed for at least 3 months presented higher exclusive breastfeeding duration and higher prevalence of being exclusively breastfed for at least 3 months. When analyses were stratified by mothers and fathers, the result remained significant only among mothers. Longer predominant breastfeeding duration in the first generation was associated with longer exclusive breastfeeding duration in the second generation, but only among older mothers. Education and social support surrounding breastfeeding should be intensified among fathers and younger parents to create a positive environment supportive of breastfeeding.     

Annual summary of vital statistics--2001

The number of births, the crude birth rate (14.5 in 2001), and the fertility rate (67.2 in 2001) all declined slightly (by 1% or less) from 2000 to 2001. Fertility rates were highest for Hispanic women (107.4), followed by Native American (70.7), Asian or Pacific Islander (69.4), black (69.3), and non-Hispanic white women (58.0). During the early to mid 1990s, fertility declined for non-Hispanic white, black, and American Indian women. Rates for these population groups have changed relatively little since 1995; however, fertility has increased for Asian or Pacific Islander and Hispanic women. The birth rate for teen mothers continued to fall, dropping 5% from 2000 to 2001 to 45.9 births per 1000 females aged 15 to 19 years, another record low. The teen birth rate has fallen 26% since 1991; declines were more rapid (35%) for younger teens aged 15 to 17 years than for older teens aged 18 to 19 years (20%). The proportion of all births to unmarried women remained about the same at one-third. Smoking during pregnancy continued to decline; smoking rates were highest among teen mothers. The use of timely prenatal care increased slightly to 83.4% in 2001. From 1990 to 2001, the use of timely prenatal care increased by 6% (to 88.5%) for non-Hispanic white women, by 23% (to 74.5%) for black women, and by 26% (to 75.7%) for Hispanic women. The number and rate of twin births continued to rise, but the triplet/+ birth rate declined for the second year in a row. For the first year in almost a decade, the preterm birth rate declined (to 11.6%); however, the low birth weight rate was unchanged at 7.6%. The total cesarean delivery rate jumped 7% from 2000 to 2001 to 24.4% of all births, the highest level reported since these data became available on birth certificates (1989). The primary cesarean rate rose 5%, whereas the rate of vaginal birth after a previous cesarean delivery tumbled 20%. In 2001, the provisional infant mortality rate was 6.9 per 1000 live births, the same as in 2000. Racial differences in infant mortality remain a major public health concern, with the rate for infants of black mothers 2.5 times those for infants of non-Hispanic white or Hispanic mothers. In 2000, 66% of all infant deaths occurred among the 7.6% of infants born low birth weight. Among all states, Maine and Massachusetts had the lowest infant mortality rates. The United States continues to rank poorly in international comparisons of infant mortality. The provisional death rate in 2001 was 8.7 deaths per 1000 population, the same as the 2000 final rate. In 2000, unintentional injuries and homicide remained the leading and second-leading causes of death for children 1 to 19 years of age, although the death rate for homicide decreased by 10% from 1999 to 2000. Among unintentional injuries to children, two-thirds were motor vehicle-related; among homicides, two-thirds were firearm-related.     

Do protective factors reduce the risk of hospitalization in infants of teenaged mothers?

OBJECTIVE: To determine the risk of hospitalization associated with prenatal care use and indicators of socioeconomic status and social support among infants of teenage mothers. DESIGN: Population-based case-control study. SETTING: Nonfederal hospitals in Washington State. PARTICIPANTS: Infants born from 1987 to 1995 to mothers younger than 20 years were identified using linked birth certificate-state hospital discharge data. Cases consisted of 8052 infants who were hospitalized during the first year of life at least 2 days after birth hospitalization discharge. An equal number of controls, frequency matched on birth year and maternal age group, were randomly sampled from among nonhospitalized infants. MAIN OUTCOME MEASURE: Hospitalization in the first year of life. RESULTS: Infants with a father listed on the birth certificate or whose mothers had commercial health insurance had a decreased risk of hospitalization (adjusted odds ratios, 0.91 and 0.78, respectively; 95% confidence intervals, 0.83-0.99 and 0.71-0.85, respectively). Participation in state-funded pregnancy programs, adequacy of prenatal care, or marital status did not affect the risk of hospitalization, except among infants whose mothers received more than adequate prenatal care (adjusted odds ratio, 1.15; 95% confidence interval, 1.03-1.29). CONCLUSION: Our results suggest that teenaged mothers who list a father on the birth certificate or who have insurance, indicative of higher socioeconomic status, may have a reduced risk of hospitalization for their infants. Teenaged mothers who receive more than adequate prenatal care may have pregnancy complications that place their infants at increased risk of hospitalization. The effect of these protective factors should be clarified in future studies.     

Relation of birth spacing with birth weight, morbidity and mortality of the newborn

A total of 410 women delivering in the U.I.S.E. Maternity Hospital in Kanpur, India, were included in a study to determine the relation of birth interval with birth weight and infant morbidity and mortality. 66.7% of the sample group had a birth spacing of less than 2 1/2 years, 25.1% between 2 1/2 and 3 1/2 years, and 8.2% above 3 1/2 years. As birth interval increased, so did mean birth weight; mean birth weight was lowest (2150 gm) when spacing was less than 1 year and exhibited an upward trend up to 3 1/2 years. 60.8% of the infants delivered at a birth interval of less than 1 year weighed less than 2000 gm compared with 11.3% of the infants born at birth interval of 3-3 1/2 years. The highest percentages of infant morbidity (52.1%) and mortality (13.1%) were found when birth spacing was less than 1 year; both rates were considerably reduced (20.5% and 2.2%, respectively) when birth spacing was 2 1/2-3 1/2 years. Birth spacing is closely related to effective family planning, and its practice may yield substantial child health benefits.