چكيده لاتين :
Background & Aims: Proper intervals between births have been emphasized as a factor to guarantee the health
of the mother and infant. Therefore, reproductive health programs are essential to achieving this important goal.
Birth intervals are an effort to maintain a certain interval between births, which is explicitly defined relative to the
newborn. Closely birth intervals are referred to as rapid repeated pregnancy in the public health and medical
literature and increase the risk of various disorders in the mother and infant. The current literature in this regard
indicates that more than 54 million women suffer from health problems during pregnancy and delivery each year,
and approximately 1.5 million die, 99% of which occur in developing countries. Since the time and interval of
subsequent births are the main determinants of fertility, fertility researchers have widely investigated these factors.
In addition, evidence suggests that short intervals between births cause numerous adverse consequences in
childhood and adulthood. The present study aimed to investigate the birth intervals and its determinants in the
rural women of Fars province, Iran. In general, we sought to identify the vulnerable groups of women that need
special attention in health and reproductive health programs, so that the general health of mothers and infants
would be promoted in the community.
Materials & Methods: This cross-sectional, analytical study was conducted using a researcher-made
questionnaire on 882 married women aged 15-49 years with two or more children living in the rural areas of Fars
province. The survey was performed using cluster sampling in October 2015. The independent variables included
age, age of the spouse, year of marriage, ethnicity, religion, education level, and occupation status. In addition,
the birth year of each child was recorded by asking the women, and birth interval was the dependent variable.
Based on the fertility level of the women, the intervals between the first and second births, as well as the second
and third births, were also considered and emphasized. Data analysis was performed in SPSS version 16 using
frequency tables and multiple regression analysis at the significance level of 0.05. Results: The mean age of the participants was 35.29±6.25 years, and the mean age of the spouses was 40.31±6.89
years. The mean age of the women in the first marriage was 19.56±3.95 years. The majority of the respondents
were Persians and Shiites, and the majority of the women (53.6%) had two children. Furthermore, 4% of the rural
women had academic education or higher educational degrees than diploma, and this rate was estimated at 5.6%
for men. The findings also indicated that the largest proportion of the rural women and their spouses had secondary
education or lower. In terms of occupation status, 3.3% of the rural women and 94.9% of the spouses were
employed. In addition, approximately 83.6% of the rural households earned less than 10 million Rials, and 0.9%
earned more than 25,000,000 million Rials per month. According to the results, 31.8% of the women with two
children gave birth to their second child less than three years after the birth of the first child. This rate was
estimated at 52%, 65.7%, and 80% for the women with three, four, and five children, respectively. The interval
between the second and third birth for 25.3%, 50.5%, and 78.8% of the women with three, four, and five children
was less than three years, respectively. On the other hand, all the women with four children gave birth to their
fourth child less than three years after their last child. The multivariate analysis of the data indicated that ethnicity
(P=0.023) and religion (P=0.002) had a significant effect on the birth interval between the first and second births,
and the average birth interval in the Persian and Shiite women was higher than the women of other ethnicities and
Sunni women. Notably, ethnicity (P=0.001) and religion (P=0.027) were the only significant variables to affect
the interval between the birth of the second and third children of the rural women in Fars province. Conclusion: According to the results, demographic and socioeconomic characteristics had relatively similar
effects on the birth interval between the first and third children, while the explanatory power of these factors
increased relatively with the interval between the second and third births. In other words, the interval between the
first and third childbirths in the rural women was relatively the same, and no significant differences were observed
in terms of the socioeconomic characteristics of the women. Ethnicity and religion also had significant effects on
the birth interval, which could be associated with the socioeconomic status of the rural women. It seems that the
employed women had to increase their birth intervals due to the combination of childbirth and occupation.
Nevertheless, no significant correlation was denoted between the occupation status of the women and birth
intervals, while our findings indicated that the employed women were more likely to give birth to their second
child within an increased interval from the first birth compared to the unemployed women, while it was the
opposite in the case of the interval between the second and third births. Previous studies have indicated that the
education level of women is a significant influential factor in birth intervals, while no such significant correlation
was observed in this study. Furthermore, it could be inferred that the Sunni and non-Persian women needed more
attention as a vulnerable population, and they should be properly trained on the importance of adequate birth
intervals. These women also need more attention to raise their awareness regarding adequate birth intervals. By
adopting and implementing the necessary training courses in vulnerable women, the issues associated with birth
intervals could reduce, which in turn promotes the general health of these women and their infants.
