Peer-reviewed article
Association between short birth spacing and child malnutrition in Bangladesh: a propensity score matching approach.
Foyez Ahmmed, Md Nahid Hasan, Md Faruk Hossain, Md Tareq Ferdous Khan, Mohammod Mahmudur Rahman et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined whether short birth spacing (less than 33 months between births) is associated with child malnutrition in Bangladesh. Using data from 4,652 households in the 2017-18 Demographic and Health Survey, researchers matched children born with short spacing to similar children born with normal spacing. Children with short birth spacing had higher rates of malnutrition, and this effect was stronger in families where mothers had more autonomy or were married very young.
Key points
- Short birth spacing (less than 33 months) was present in 22.16% of cases
- Children with short birth spacing had 25% higher odds of multiple concurrent forms of malnutrition
- Children with short birth spacing had 20% higher odds of at least one form of malnutrition
- The harmful effect was stronger among mothers with high empowerment and autonomy (43% higher odds)
- Mothers married at age 18 or younger showed stronger negative effects of short birth spacing on child malnutrition (27% and 23% higher odds)
Limitations
This is observational data showing association, not causation. The study cannot determine whether short birth spacing directly causes malnutrition or whether unmeasured factors influence both spacing and malnutrition outcomes.
Abstract
OBJECTIVES: This study aimed to explore the effects of short birth spacing (SBS), which is defined as a period of less than 33 months between two successive births, on multiple concurrent forms of child malnutrition (MCFCM) and at least one form of child malnutrition (ALOFCM) using propensity score matching (PSM). METHODS: This study used data extracted from the 2017-18 Bangladesh Demographic and Health Survey. PSM with four different distance functions, including logistic regression, classification and regression tree, single hidden layer neural network and random forest, were performed to evaluate the effects of SBS on MCFCM and ALOFCM. We also explored how the effects were modified in different subsamples, including women's empowerment, education and economic status (women's 3E index)-constructed based on women's decision-making autonomy, education level, and wealth index, and age at marriage, and place of residence. RESULTS: The prevalence of SBS was 22.16% among the 4652 complete cases. The matched samples of size 2062 generated by PSM showed higher odds of MCFCM (adjusted OR (AOR)=1.25, 95% CI=1.02 to 1.56, p=0.038) and ALOFCM (AOR=1.20, 95% CI=1.01 to 1.42, p=0.045) for the SBS children compared with their counterparts. In the subsample of women with 3E index≥50% coverage, the SBS children showed higher odds of MCFCM (AOR: 1.43, 95% CI=1.03 to 2.00, p=0.041] and ALOFCM (AOR: 1.33, 95% CI=1.02 to 1.74, p=0.036). Higher odds of MCFCM (AOR=1.27, 95% CI=1.02 to 1.58, p=0.036) and ALOFCM (AOR=1.23, 95% CI=1.02 to 1.51, p=0.032) for SBS children than normal children were also evident for the subsample of mothers married at age≤18 years. CONCLUSION: SBS was significantly associated with child malnutrition, and the effect was modified by factors such as women's autonomy and age at marriage.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- None; this is an observational study examining the natural association between short birth spacing and child malnutrition outcomes
- Population
- 4,652 children from the 2017-18 Bangladesh Demographic and Health Survey, with propensity score matched sample of 2,062
Key finding
Children with short birth spacing had adjusted odds ratio of 1.25 (95% CI: 1.02-1.56, p=0.038) for multiple concurrent forms of malnutrition
Ahmmed et al. · PubMed (US National Library of Medicine) · 18 Mar 2024