Relationship between survival status of first child and subsequent child death

Abstract

This paper examines the association between infant mortality of the first born and subsequent children using data from rural Bangladesh collected during the period 1971-82. It shows that birth spacing and age of mother at the time of the second birth are important predictors of the survival status of the first child. The findings are discussed in terms of policy implications.

PIP: This study examines the mortality of the first born and the death of a subsequent child in Bangladesh. Data are obtained from the Demographic Surveillance System of the International Center for Diarrheal Disease Research during 1974-82. The sample includes 1772 mothers who had first births and 1032 who had second births. 245 first-born and 159 second-born infants died. 740 mothers of first-born infants did not have a second child. 176 women had signs of secondary infertility. Bivariate analysis of the correspondence between first mortality status and age at death of the second child indicates an inverse relationship. The probabilities of neonatal or infant death among second children were highest among mothers whose first child also died neonatally. The second-birth mortality risk was consistently higher for all mortality among first births up to 1 year of age and lower if the first birth survived the neonatal stage. Risk was higher among mothers aged under 20 years and if the second child was a male. If the first child was a male, the probability of the second child surviving was higher. The hazard model analysis reveals that birth spacing was an important determinant. Shorter birth interval between first and second births was related to a higher relative risk of dying among first births. The analysis suggests that birth spacing and maternal age at the time of the second birth were important factors relating to the survival status of the second child. The implication of the findings is that biological variables, such as birth weight, may offer a better explanation for the association between socioeconomic and demographic factors and infant mortality. Health interventions, such as child care and nutrition education, may be more effective in reducing the risk of subsequent mortality