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Hassen TA, Chojenta C, Khan MN, Shifti DM, Harris ML. Short birth interval in the Asia-Pacific region: A systematic review and meta-analysis. J Glob Health 2024; 14:04072. [PMID: 38700432 PMCID: PMC11067827 DOI: 10.7189/jogh.14.04072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Abstract
Background Short birth interval is associated with an increased risk of adverse health outcomes for mothers and children. Despite this, there is a lack of comprehensive evidence on short birth interval in the Asia-Pacific region. Thus, this study aimed to synthesise evidence related to the definition, classification, prevalence, and predictors of short birth interval in the Asia-Pacific region. Methods Five databases (MEDLINE, Scopus, Cumulative Index to Nursing and Allied Health Literature, Maternity and Infant Care, and Web of Science) were searched for studies published between September 2000 and May 2023 (the last search was conducted for all databases in May 2023). We included original studies published in English that reported on short birth interval in the Asia-Pacific region. Studies that combined birth interval with birth order, used multi-country data and were published as conference abstracts and commentaries were excluded. Three independent reviewers screened the articles for relevancy, and two reviewers performed the data extraction and quality assessment. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool. The findings were both qualitatively and quantitatively synthesised and presented. Results A total of 140 studies met the inclusion criteria for this review. About 58% (n = 82) of the studies defined short birth interval, while 42% (n = 58) did not. Out of 82 studies, nearly half (n = 39) measured a birth-to-birth interval, 37 studies measured a birth-to-pregnancy, four measured a pregnancy-to-pregnancy, and two studies measured a pregnancy loss-to-conception. Approximately 39% (n = 55) and 6% (n = 8) of studies classified short birth intervals as <24 months and <33 months, respectively. Most of the included studies were cross-sectional, and about two-thirds had either medium or high risk of bias. The pooled prevalence of short birth interval was 33.8% (95% confidence interval (CI) = 23.0-44.6, I2 = 99.9%, P < 0.01) among the studies that used the World Health Organization definition. Conclusions This review's findings highlighted significant variations in the definition, measurement, classification, and reported prevalence of short birth interval across the included studies. Future research is needed to harmonise the definition and classification of short birth interval to ensure consistency and comparability across studies and facilitate the development of targeted interventions and policies. Registration PROSPERO CRD42023426975.
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Affiliation(s)
- Tahir Ahmed Hassen
- Centre for Women's Health Research, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Australia
| | - Catherine Chojenta
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Australia
| | - Md Nuruzzaman Khan
- Centre for Women's Health Research, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Australia
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
| | - Desalegn Markos Shifti
- Centre for Women's Health Research, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Australia
- Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Melissa Leigh Harris
- Centre for Women's Health Research, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Australia
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Ding W, Xu Y, Kondracki AJ, Sun Y. Childhood adversity and accelerated reproductive events: a systematic review and meta-analysis. Am J Obstet Gynecol 2024; 230:315-329.e31. [PMID: 37820985 DOI: 10.1016/j.ajog.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 09/18/2023] [Accepted: 10/02/2023] [Indexed: 10/13/2023]
Abstract
OBJECTIVE Accelerated female reproductive events represent the early onset of reproductive events involving puberty, menarche, pregnancy loss, first sexual intercourse, first birth, parity, and menopause. This study aimed to explore the association between childhood adversity and accelerated female reproductive events. DATA SOURCES PubMed, Web of Science, and Embase were systematically searched from September 22, 2022 to September 23, 2022. STUDY ELIGIBILITY CRITERIA Observational cohort, cross-sectional, and case-control studies in human populations were included if they reported the time of reproductive events for female individuals with experience of childhood adversity and were published in English. METHODS Two reviewers independently screened studies, obtained data, and assessed study quality, and conflicts were resolved by a third reviewer. Dichotomous outcomes were evaluated using meta-analysis, and pooled odds ratios and 95% confidence intervals were generated using random-effects models. Moderation analysis and meta-regression were used to investigate heterogeneity. RESULTS In total, 21 cohort studies, 9 cross-sectional studies, and 3 case-control studies were identified. Overall, female individuals with childhood adversity were nearly 2 times more likely to report accelerated reproductive events than those with no adversity exposure (odds ratio, 1.91; 95% confidence interval, 1.33-2.76; I2=99.6%; P<.001). Moderation analysis indicated that effect sizes for the types of childhood adversity ranged from an odds ratio of 1.61 (95% confidence interval, 1.23-2.09) for low socioeconomic status to 2.13 (95% confidence interval, 1.14-3.99) for dysfunctional family dynamics. Among the 7 groups based on different reproductive events, including early onset of puberty, early menarche, early sexual initiation, teenage childbirth, preterm birth, pregnancy loss, and early menopause, early sexual initiation had a nonsignificant correlation with childhood adversity (odds ratio, 2.70; 95% confidence interval, 0.88-8.30; I2=99.9%; P<.001). Considerable heterogeneity (I2>75%) between estimates was observed for over half of the outcomes. Age, study type, and method of data collection could explain 35.9% of the variance. CONCLUSION The literature tentatively corroborates that female individuals who reported adverse events in childhood are more likely to experience accelerated reproductive events. This association is especially strong for exposure to abuse and dysfunctional family dynamics. However, the heterogeneity among studies was high, requiring caution in interpreting the findings and highlighting the need for further evaluation of the types and timing of childhood events that influence accelerated female reproductive events.
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Affiliation(s)
- Wenqin Ding
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Yuxiang Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Anthony J Kondracki
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA
| | - Ying Sun
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China; Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Ministry of Education of the People's Republic of China, Hefei, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, Hefei, China.
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Beetham KS, Spathis JG, Hoffmann S, Brown WJ, Clifton V, Mielke GI. Longitudinal association of physical activity during pregnancy with maternal and infant outcomes: Findings from the Australian longitudinal study of women's health. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221142357. [PMID: 36560920 PMCID: PMC9793022 DOI: 10.1177/17455057221142357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Physical activity has known benefits during pregnancy; however, the optimum volume of physical activity through the different stages of pregnancy is not well known. OBJECTIVES The aims of this study were to investigate the associations of physical activity volume in pregnant women in each trimester of pregnancy with maternal and infant outcomes. DESIGN The study involved 1657 pregnant women from the Australian Longitudinal Study on Women's Health, who completed surveys from 2006 to 2012 (aged 28-39 years). METHODS Women reported being in either the first, second or third trimester of pregnancy. Women were grouped into four groups according to their self-reported physical activity during pregnancy: (1) Nil (0-<33.3 MET.min/week), (2) Low (33.3-<500 MET.min/week), (3) Moderate (500-<1000 MET.min/week) and (4) High (⩾1000 MET.min/week). Women who reported their physical activity during pregnancy completed a survey within three years after the birth, relating to outcomes associated with pregnancy and childbirth (gestational diabetes, hypertension, and antenatal depression and anxiety) and infant outcomes (birthweight and prematurity). RESULTS There was no association of physical activity in any trimester with infant birthweight, prematurity, gestational diabetes, hypertension or antenatal depression. Antenatal anxiety was less prevalent in women who reported low (1.7%) or moderate (1.1%) physical activity than in those who reported no activity (4.7%; p = 0.01). CONCLUSION Different amounts of physical activity during pregnancy were not associated with the measured adverse health outcomes. However, low and moderate amounts of physical activity were associated with reduced incidence of antenatal anxiety.
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Affiliation(s)
- Kassia S Beetham
- School of Behavioural and Health
Sciences, Australian Catholic University, Brisbane, QLD, Australia,School of Exercise and Nutrition
Sciences, Deakin University, Geelong, VIC, Australia,Kassia S Beetham, School of Behavioural and
Health Sciences, Australian Catholic University, 1100 Nudgee Road, Banyo,
Brisbane, QLD, 4014, Australia.
| | - Jemima G Spathis
- School of Behavioural and Health
Sciences, Australian Catholic University, Brisbane, QLD, Australia
| | - Samantha Hoffmann
- School of Exercise and Nutrition
Sciences, Deakin University, Geelong, VIC, Australia
| | - Wendy J Brown
- School of Human Movement and Nutrition
Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Vicki Clifton
- Mater Research and Translational
Research Institute, Brisbane, QLD, Australia
| | - Gregore I Mielke
- School of Public Health, The University
of Queensland, Brisbane, QLD, Australia
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Fertility Dynamics and Life History Tactics Vary by Socioeconomic Position in a Transitioning Cohort of Postreproductive Chilean Women. HUMAN NATURE 2022; 33:83-114. [PMID: 35612730 PMCID: PMC9250487 DOI: 10.1007/s12110-022-09425-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/28/2022] [Indexed: 10/26/2022]
Abstract
AbstractGlobally, mortality and fertility rates generally fall as resource abundance increases. This pattern represents an evolutionary paradox insofar as resource-rich ecological contexts can support higher numbers of offspring, a component of biological fitness. This paradox has not been resolved, in part because the relationships between fertility, life history strategies, reproductive behavior, and socioeconomic conditions are complex and cultural-historically contingent. We aim to understand how we might make sense of this paradox in the specific context of late-twentieth-century, mid–demographic transition Chile. We use distribution-specific generalized linear models to analyze associations between fertility-related life-history traits—number of offspring, ages at first and last reproduction, average interbirth interval, and average number of live births per reproductive span year—and socioeconomic position (SEP) using data from a cohort of 6,802 Chilean women born between 1961 and 1970. We show that Chilean women of higher SEP have shorter average interbirth intervals, more births per reproductive span year, later age at first reproduction, earlier ages at last reproduction, and, ultimately, fewer children than women of lower SEP. Chilean women of higher SEP consolidate childbearing over a relatively short time span in the middle of their reproductive careers, whereas women of lower SEP tend to reproduce over the entirety of their reproductive lifespans. These patterns may indicate that different SEP groups follow different pathways toward declining fertility during the demographic transition, reflecting different life-history trade-offs in the process.
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Gong J, Harris K, Peters SAE, Woodward M. Reproductive factors and the risk of incident dementia: A cohort study of UK Biobank participants. PLoS Med 2022; 19:e1003955. [PMID: 35381014 PMCID: PMC8982865 DOI: 10.1371/journal.pmed.1003955] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 02/23/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Women's reproductive factors have been associated with the risk of dementia; however, these findings remain uncertain. This study aimed to examine the risk of incident all-cause dementia associated with reproductive factors in women and the number of children in both sexes and whether the associations vary by age, socioeconomic status (SES), smoking status, and body mass index (BMI) in the UK Biobank. METHODS AND FINDINGS A total of 273,240 women and 228,957 men without prevalent dementia from the UK Biobank were included in the analyses. Cox proportional hazard regressions estimated hazard ratios (HRs) for reproductive factors with incident all-cause dementia. Multiple adjusted models included age at study entry, SES, ethnicity, smoking status, systolic blood pressure, BMI, history of diabetes mellitus, total cholesterol, antihypertensive drugs, and lipid-lowering drugs. Over a median of 11.8 years follow-up, 1,866 dementia cases were recorded in women and 2,202 in men. Multiple adjusted HRs ((95% confidence intervals (CIs)), p-value) for dementia were 1.20 (1.08, 1.34) (p = 0.016) for menarche <12 years and 1.19 (1.07, 1.34) (p = 0.024) for menarche >14 years compared to 13 years; 0.85 (0.74, 0.98) (p = 0.026) for ever been pregnant; 1.43 (1.26, 1.62) (p < 0.001) for age at first live birth <21 compared to 25 to 26 years; 0.82 (0.71, 0.94) (p = 0.006) for each abortion; 1.32 (1.15, 1.51) (p = 0.008) for natural menopause at <47 compared to 50 years; 1.12 (1.01, 1.25) (p = 0.039) for hysterectomy; 2.35 (1.06, 5.23) (p = 0.037) for hysterectomy with previous oophorectomy; and 0.80 (0.72, 0.88) (p < 0.001) for oral contraceptive pills use. The U-shaped associations between the number of children and the risk of dementia were similar for both sexes: Compared with those with 2 children, for those without children, the multiple adjusted HR ((95% CIs), p-value) was 1.18 (1.04, 1.33) (p = 0.027) for women and 1.10 (0.98, 1.23) (p = 0.164) for men, and the women-to-men ratio of HRs was 1.09 (0.92, 1.28) (p = 0.403); for those with 4 or more children, the HR was 1.14 (0.98, 1.33) (p = 0.132) for women and 1.26 (1.10, 1.45) (p = 0.003) for men, and the women-to-men ratio of HRs was 0.93 (0.76, 1.14) (p = 0.530). There was evidence that hysterectomy (HR, 1.31 (1.09, 1.59), p = 0.013) and oophorectomy (HR, 1.39 (1.08, 1.78), p = 0.002) were associated with a higher risk of dementia among women of relatively lower SES only. Limitations of the study include potential residual confounding and self-reported measures of reproductive factors, as well as the limited representativeness of the UK Biobank population. CONCLUSIONS In this study, we observed that some reproductive events related to shorter cumulative endogenous estrogen exposure in women were associated with higher dementia risk, and there was a similar association between the number of children and dementia risk between women and men.
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Affiliation(s)
- Jessica Gong
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia
- * E-mail:
| | - Katie Harris
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia
| | - Sanne A. E. Peters
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia
- The George Institute for Global Health, Imperial College London, London, United Kingdom
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, the Netherlands
| | - Mark Woodward
- The George Institute for Global Health, University of New South Wales, Newtown, New South Wales, Australia
- The George Institute for Global Health, Imperial College London, London, United Kingdom
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Oura P. Sociodemographic Indicators of Birth Rate in a Low Fertility Country-A Nationwide Study of 310 Finnish Municipalities Covering > 5,000,000 Inhabitants. Front Public Health 2021; 9:643561. [PMID: 33968881 PMCID: PMC8104080 DOI: 10.3389/fpubh.2021.643561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/29/2021] [Indexed: 11/30/2022] Open
Abstract
Background and Aims: Declining fertility is a key driver behind the rapid aging of populations worldwide. Finland has experienced a 25% decline in fertility from 2010 to date and ranks low even on the European and Nordic scales. This study aimed to address the association between sociodemographic indicators and birth rate (i.e., live births relative to total population) in Finland. Methods: Open data on 310 Finnish municipalities were retrieved from the public database of Statistics Finland. Several sociodemographic subdimensions (population structure, education and income, location and living, divorces, car ownership rate, and crime rate), each converted to standard deviation units, were modeled against birth rate at the municipality level using generalized estimating equations. Results: In this dataset, average annual birth rate was 8.8 per 1,000 individuals. Birth rate was positively associated with change in population size (rate ratio 1.06, 95% confidence interval 1.04−1.08), percentage of <15-year-olds (1.29, 1.22−1.36), percentage of individuals living in their birth municipality (1.05, 1.03−1.08), and percentage of foreign language speakers (1.02, 1.01−1.04). In contrast, birth rate was negatively associated with percentage of ≥65-year-olds (0.90, 0.85−0.96), percentage of unemployed individuals (0.98. 0.95−0.99), income (0.92, 0.89−0.96), and number of individuals living in the same household unit (0.94, 0.90−0.98). Conclusion: The present findings are expected to advance the allocation of resources to areas and subpopulations that have high or low birth rate, and thus contribute to the development of a more family-friendly society. Future studies are encouraged to evaluate the sociodemographic indicators of birth rate in other low fertility countries, and to address the individual-level mechanisms behind the municipality-level associations identified in this study.
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Affiliation(s)
- Petteri Oura
- Department of Forensic Medicine, University of Helsinki, Helsinki, Finland.,Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
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Luo L, Fan XZ, Jie HY, Gao Y, Chen M, Zhou C, Wang Q. Is it worth reducing twins to singletons after IVF-ET? A retrospective cohort study using propensity score matching. Acta Obstet Gynecol Scand 2019; 98:1274-1281. [PMID: 31081540 DOI: 10.1111/aogs.13640] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Many studies have shown that multifetal reduction of high-order multiple pregnancies results in improved pregnancy outcomes. However, whether conducting elective fetal reduction from dichorionic twins after in vitro fertilization (IVF) is worthwhile remains controversial. This study aimed to determine whether elective fetal reduction of dichorionic twins after IVF and embryo transfer (IVF-ET) is associated with increased take-home baby rate. MATERIAL AND METHODS This was a retrospective cohort study of 3600 dichorionic twin pregnancies after IVF-ET. The reduced group included 71 women with transvaginal elective fetal reduction between 7 and 8 weeks of gestation. The control group (n = 3529) comprised women who were managed expectantly. Propensity score matching was conducted before pregnancy outcomes were compared. RESULTS The take-home baby rate was significantly lower in the reduced group (83.1% vs 92.8%, P = 0.004). The total miscarriage rate was significantly higher in the reduced group (12.7% vs 6.2%, P = 0.04). Although preterm delivery rate was lower in the reduced group (P < 0.001), over 90% were over 32 weeks, whereas the proportions were equal in the reduced group. CONCLUSIONS In dichorionic twin pregnancies after IVF-ET, elective fetal reduction to singleton significantly decreased the chance of taking home live babies.
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Affiliation(s)
- Lu Luo
- The Center of Reproductive Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Xiong-Zhi Fan
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Hui-Ying Jie
- The Center of Reproductive Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Yong Gao
- The Center of Reproductive Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Minghui Chen
- The Center of Reproductive Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Canquan Zhou
- The Center of Reproductive Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
| | - Qiong Wang
- The Center of Reproductive Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Reproductive Medicine, Guangzhou, China
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