Birth spacing and infant mortality in Brazil

Curtis, S.L. and McDonald, J.W. (1991) Birth spacing and infant mortality in Brazil. Journal of Biosocial Science, 23 (3), 343-352. (doi:10.1017/S0021932000019404). (PMID:1885631)

Record type: Article

Abstract

The effects of birth spacing on neonatal and post-neonatal mortality in Brazil were found to be very consistent with models based on data from other South American countries. The model for neonatal mortality simplified to three significant variables, whereas the model for post-neonatal mortality included four significant interactions.

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Published date: July 1991

Additional Information: Researchers used 1986 data from the Brazil Demographic and Health Survey to determine the effects of birth spacing on neonatal and post neonatal mortality then compared the results with other countries (World Fertility Survey). 1st births had a higher relative risk (RR) of neonatal death (1.49) than births of order 203 Brazil. A similar pattern existed for Peru, Ecuador, Costa Rica, Colombia, and Guyana. In Brazil, 4-6 birth order had the lowest risk (.62). High order births (7+) for all the countries had an RR almost the same as the baseline 2-3 birth order class. Birth order was significant (p<.01). Post neonatal mortality for 1st births in Brazil was more favorable than other countries, but the RR for high order births was less favorable. The RR of neonatal mortality declined with mother's education for Brazil (p<.05) as well as it did for Peru, Ecuador, Colombia, and Costa Rica. It did not fall in Guyana, however, where it was elevated (1.19) for mothers with 4-6 years of schooling. The positive effect of maternal education was even stronger for post neonatal mortality in Brazil (.62 for 4.6 years and .27 for 7+ years). The effect was basically the same for all the countries, but mothers with 4-6 years of education in Guyana (1.03) had slightly higher post neonatal mortality. The RR of neonatal mortality for the index child if there were 1 surviving sibling born 0-2 years earlier was only slightly increased (1.25) in Brazil, but if there were 1 dead sibling born 0-2 years earlier, RR stood at 2.4 and was significant. This RR rose further if 2 or more children were born in this interval (3.71). For infants in Brazil who had 2+ siblings born 2-4 years earlier, the RR of neonatal mortality was elevated (1.83). Indeed Brazil had higher neonatal mortality for these children than did the other countries. Birth spacing was highly significant (p<.001).