Expected reductions in fetal and infant mortality by prolonged pregnancy spacing in rural Bangladesh

Abstract

The effect of pregnancy spacing on fetal and infant survivorship is explored using a life table method. The proportions of detected pregnancies surviving to term and to the beginning of the second year of life are calculated by different lengths of preceding interval, age of the mother, pregnancy order, and the mother's fertility history. The study population consists of the second pregnancies in 9295 intervals recorded in Matlab than between 1966-71. Results indicate that if all pregnancies were preceded by an interpregnancy interval longer than 24 months, about 5% more would survive to the second year of life. The corresponding gain would be 2% with an interval of 12-24 months. Pregnancies following intervals of less than 12 months and a surviving live birth experience the poorest survivorship: lower than first order pregnancies, pregnancies to women over 39, or pregnancies of women with a history or 2 or more pregnancy or child losses. If all second and above order pregnancies were preceded by an interval longer than 24 months, the expected early fetal wastage rate would decline by about 42%. If all second and above order pregnancies were preceded by intervals longer than 24 months, postneonatal mortality would be expected to decline by about 44%. Results of the analysis indicate that the impact of pregnancy spacing in decreasing early fetal and postneonatal mortality greatly exceeds that of averting births in the high-risk subclasses for other maternal factors