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- Molitoris, Joseph
(författare)
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Breast-feeding during Pregnancy and the Risk of Miscarriage
- 2019
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Ingår i: Perspectives on Sexual and Reproductive Health. - : Guttmacher Institute. - 1931-2393 .- 1538-6341. ; 51:3, s. 153-163
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Tidskriftsartikel (refereegranskat)abstract
- ContextBreastfeeding rates and durations have been increasing among American women in recent decades, but a consequence of these trends is that women may be more likely to practice breastfeeding during pregnancy (BDP). BDP has been hypothesized to increase the risk of miscarriage, yet there has been little research investigating if this is the case.MethodsUsing data on 10,661 pregnancies from the National Survey of Family Growth spanning 2002-2015, unadjusted miscarriage rates were calculated according to BDP status. Multivariate Cox proportional hazards models were used to investigate the association between BDP and the risk of miscarriage.ResultsBDP was practiced in 6.1% of the total time at risk of miscarriage. The miscarriage rate was elevated when mothers exclusively BDP (98.4 per 1000 person-months at risk) compared to when mothers were either complementary BDP or not breastfeeding. After adjusting for maternal and pregnancy characteristics, there was a nearly four-fold increase in the risk of miscarriage when mothers practiced exclusive BDP versus not breastfeeding and no increased risk associated with complementary BDP. The magnitude of the increase during exclusive BDP was similar to that of women who conceived above age 40, a well-known predictor of pregnancy loss.ConclusionExclusive BDP is associated with a heightened risk of miscarriage, but it remains unclear how the practice is associated with outcomes of the mother and breastfed child. More research is therefore needed to understand all of these potential relationships before any firm recommendations on the safety of the practice should be made.
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| 2. |
- Molitoris, Joseph
(författare)
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Longer birth intervals can reduce infant mortality in poor countries
- 2019
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Ingår i: N-IUSSP. - 2704-7067.
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Recent work on wealthy populations has called into question long-standing conclusions about the importance of birth spacing for infant health. Using data from 77 countries, Joseph Molitoris and colleagues show that spacing births beyond 24 months can greatly reduce infant mortality risks, but that the benefits of birth spacing decline with socioeconomic and demographic development.
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| 3. |
- Molitoris, Joseph, et al.
(författare)
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When and Where Birth Spacing Matters for Child Survival : An International Comparison Using the DHS
- 2019
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Ingår i: Demography. - : Duke University Press. - 0070-3370 .- 1533-7790. ; 56:4, s. 1349-1370
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Tidskriftsartikel (refereegranskat)abstract
- A large body of research has found an association between short birth intervals and the risk of infant mortality in developing countries, but recent work on other perinatal outcomes from highly developed countries has called these claims into question, arguing that previous studies have failed to adequately control for unobserved heterogeneity. Our study addresses this issue by estimating within-family models on a sample of 4.5 million births from 77 countries at various levels of development. We show that after unobserved maternal heterogeneity is controlled for, intervals shorter than 36 months substantially increase the probability of infant death. However, the importance of birth intervals as a determinant of infant mortality varies inversely with maternal education and the strength of the relationship varies regionally. Finally, we demonstrate that the mortality-reducing effects of longer birth intervals are strong at low levels of development but decline steadily toward zero at higher levels of development. These findings offer a clear way to reconcile previous research showing that birth intervals are important for perinatal outcomes in low-income countries but are much less consequential in high-income settings.
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