Peer-reviewed article

Predictors of marriage to first birth interval in Amhara regional state, Ethiopia: survival analysis.

Negash BT, Tsegaye TG, Azeze GA, Zewude YA · 22 Nov 2025

Abstract

Background The timing of a woman's first birth after marriage plays a crucial role in determining both maternal and newborn health outcomes. However, studies show that this time period differs greatly between cultures and regions, and there is little research specifically on this topic in the Amhara region. Objective The aim of this study was to assess timing from first marriage to birth, and associated factors among women of reproductive age in Amhara region, Ethiopia in 2016. Methods A detailed analysis of 2016 Ethiopian Demographic and Health Survey data was conducted. The analysis comprised a total weighted sample of 1114 married women of reproductive age in Amhara region, Ethiopia. We right -censored the duration of time from marriage to first birth. We have done parametric survival analysis in this study. The Kaplan-Meier survival function was employed to analyze event timings, while the Cox Proportional Hazards (CPH) model was used to model factors affecting first birth interval. Results The median time for first birth interval in Amhara, Ethiopia was 32 months (95% CI: 30-34) and decreased with delayed age at marriage. On one hand women's higher education status Adjusted Hazard Ratio (AHR) = 1.97 (95% CI: 1.22, 3.2), women's' marriage decided by others AHR = 4.44 (95% CI: 1.6, 12.1) are associated with longer marriage to first birth interval. On the other hand, covariates such as women- headed household Adjusted Hazard Ratio (AHR) = 0.68 (95% CI: 0.53, 0.90), and women whose marriage decided by parents Adjusted Hazard Ratio (AHR) = 0.71 (95% CI: 0.57, 0.88) are associated with shorter FBI. Conclusions Although the median time from first marriage to first birth is above the WHO's minimum threshold, it is still shorter than in other regions." Women's higher education, Marriage decided by others are factors associated with longer duration of FBI. Conversely, parents decided on marriage, female-headed household are factors associated shorter FBI. Promoting women's empowerment and decision-making power is essential to increase the time between marriage and first birth.