Centre for the Study of Regional Development, School of Social Sciences, Jawaharlal Nehru University (JNU), New Delhi, India.
International Center for Research on Women (ICRW), New Delhi, India.
Public Health. 2019 Apr;169:14-25. doi: 10.1016/j.puhe.2018.11.019. Epub 2019 Feb 14.
In an effort to provide recommendation for maximizing synergy between maternal, infant, and young children's nutrition and family planning in India, this study makes a comprehensive assessment of the effects of the planning of births in terms of timing, spacing and limiting childbearing on maternal and child health outcomes.
This study used the latest National Family Health Survey data of India that is globally known as the Demographic and Health Survey. A robust two-stage systematic random sampling was used for selecting representative samples for measuring demographic and health indicators.
Maternal and child health outcomes are measured by body mass index (grouped as normal, underweight, and overweight) and anemia for mothers, and stunting, underweight, anemia, and under-five mortality for the children. Logistic regression and Cox proportional hazard models were applied.
Women with a higher number of births and among those with first-order births with fewer than 2 years between marriage and first birth, the risk of being underweight and having anemia was significantly higher compared with their counterparts. In addition, the probability of being underweight and risk of stunting, anemia, and mortality was higher among the children from women with a higher number of births and with fewer than 3 years of spacing between births than that of their counterparts.
The findings from this study support the importance of birth planning in improving maternal, child health, and nutritional outcomes. The proper planning of births could help to achieve the Sustainable Development Goal-3 of good health and well-being for all by 2030 in India, where a significant proportion of women still participate in early marriages, early childbearing, and a large number of births with close spacing.
为了在印度的母婴儿童营养与计划生育之间提供协同作用的建议，本研究对生育规划的时间、间隔和生育限制对母婴健康结果的影响进行了全面评估。
本研究使用了印度最新的国家家庭健康调查数据，该数据在全球被称为人口与健康调查。采用了稳健的两阶段系统随机抽样方法，为衡量人口和健康指标选择具有代表性的样本。
采用体质指数（分为正常、体重不足和超重）和母亲贫血来衡量母婴健康结果，用发育迟缓、体重不足、贫血和五岁以下儿童死亡率来衡量儿童健康结果。应用了逻辑回归和 Cox 比例风险模型。
与对照组相比，分娩次数较多的女性和首次分娩之间间隔少于 2 年的女性，体重不足和贫血的风险明显更高。此外，与对照组相比，分娩次数较多且分娩间隔少于 3 年的女性的孩子体重不足、发育迟缓、贫血和死亡率的风险更高。
本研究的结果支持生育规划在改善母婴健康和营养结果方面的重要性。适当的生育规划有助于印度实现到 2030 年人人享有良好健康和福祉这一可持续发展目标 3，因为印度仍有相当一部分妇女早婚、早育且生育间隔较近、生育较多。
