ArticleBMC pregnancy and childbirth2025
Effects of pregnancy intention, interpregnancy interval and postpartum contraception uptake on child survival: insights from the Indian demographic health surveys.
Article in BMC pregnancy and childbirth, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundUnintended pregnancy and short Interpregnancy Interval (IPI) are believed to have detrimental effects on child survival. To reduce infant mortality through improved Family Planning (FP), a better understanding of factors driving pregnancy intention, IPI and postpartum contraception uptake and how this decision affects infant survival is needed. Thus, this paper aimed to examine the effects of pregnancy intention, IPI and postpartum contraception uptake on infant mortality in India.
methodsData were drawn from the 2015-16 and 2019-21 National Family Health Survey (NFHS). The main outcome measure was infant mortality. The key exposure variables were pregnancy intention, IPI and postpartum contraception uptake. To fulfil the study objective, a time-to-event approach was applied to the analysis using the Kaplan-Meier survival function, Log-Rank Chi-square test and Cox-Proportional Hazard (Cox-PH) model.
resultsThe results showed that the proportion of infants WHO died during the first year after birth declined by only 0.4%, from 3.8% in 2015-16 and 3.4% in 2019-21. The Cox-PH models revealed strongly significant associations between pregnancy intention, IPI, and postpartum contraception uptake with infant mortality in both NFHS rounds, even after controlling for socio-economic, demographic and program-related factors. Besides, mother's age at last birth, parity, antenatal visits, place and mode of delivery, postnatal check-up, breastfeeding, distance to nearest health facility, media exposure, level of education, religion, caste, wealth index, place and region of residence emerged as significant factors associated with infant mortality.
conclusionThe findings of this paper reinforced an inescapable need for implementing effective programmatic interventions for the quality of FP counselling and monitoring to enhance postpartum modern contraception uptake as a way of helping young women to avert unintended pregnancy and achieve optimal IPI that would eventually lead to improving child survival among infants in India.
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