Dr. Jim Shelton's Pearls "Pearl" for the week of July 26, 2004

Birth Interval and Maternal Health

Q:I'm familiar with the impact of birth-spacing on child survival, but are birth intervals also related to the health of the mother in the developing world?

A:Yes, although it's only the very short birth intervals that appear to afford higher risk. In a very large study of more than 520,000 births in 18 countries in Latin America, after controlling for a number of variables, birth intervals of less than 15 months were associated with maternal mortality levels that were 2.5 times as high as longer intervals. These short intervals were also associated with higher rates of third trimester bleeding, premature rupture of membranes, puerperal endometritis, and anemia.

Interestingly, very long birth intervals (65 months or more) were associated with higher risk of eclampsia and pre-eclampsia.

Reference: Conde-Agudelo A, Belizan J. Maternal morbidity and mortality associated with interpregnancy interval: cross sectional study. BMJ 2000; 321:1255-9.



The "Pearls" offer answers to commonly asked questions about family planning. These "Pearls" are prepared by Dr. James D. Shelton, Senior Medical Scientist, Office of Population, United States Agency for International Development (USAID)