Determinants of Birth Intervals Using PWP-Gap Time Model: Tehran Case Study

Document Type : Original Article

Authors

National Institute for Population Research, Tehran, Iran

Abstract

 
Background:
 Total fertility rate (TFR) in Iran decreased from the year 2000 and recently Iran has experienced fertility rates below replacement level. Birth interval is one of the most important determinants of fertility levels and plays a vital role in population growth rate. Due to the importance of this subject, the aim of this study was analyzing three birth intervals using three Survival Recurrent Event (SRE) models.
 
Materials and Methods:
In a 2017 cross-sectional fertility survey in Tehran, 610 married women, age 15-49 years, were selected by multi-stage stratified random sampling and interviewed using a structured questionnaire. The effects of selected covariates on first, second and third birth intervals were fitted to the data using the Prentice-Williams- Peterson-Gap Time (PWP-GT) SRE model in SAS 9.4.
 
Results:
Calendar-period had a significant effect on all three birth intervals (p <0.01). The Hazard Rate (HR) for a short birth interval for women in the most recent calendar-period (2007-2017) was lower than for the other calendarperiods. Women’s migration influenced second (P=0.044) and third birth intervals (P=0.031). The HR for both birth intervals in migrant women was 1.298 and 1.404 times shorter, respectively than non-migrant women. Women’s employment (P=0.008) and place of residence (p <0.05) also had significant effects on second birth interval; employed women and those living in developed, completely-developed and semi-developed areas, compared to unemployed women and those living in developing regions, had longer second birth intervals. Older age at marriage age increased the HR for a short third birth interval (p <0.01).
 
Conclusion:
 The analysis of birth interval patterns using an appropriate statistical method provides important information for health policymakers. Based on the results of this study, younger women delayed their childbearing more than older women. Migrant women, unemployed women and women who live in developing regions gave birth to their second child sooner than non-migrant employed women, and women who lived in more developed regions. The implementation of policies which change the economic and social conditions of families could prevent increasing birth intervals and influence the fertility rate.

Keywords


1. Khan JR, Bari W, Latif AH. Trend of determinants of birth interval dynamics in Bangladesh. BMC Public Health. 2016; 16(1): 934.
2. Hosseini-Chavoshi M, Abbasi-Shavazi MJ, McDonald P. Fertility, marriage, and family planning in Iran: Implications for future policy. Population Horizons. 2016; 13(1): 31-40.
3. Poorolajal J. Resistance economy and new population policy in Iran. J Res Health Sci. 2017; 17(1): e00367.
4. Sajid A, Mehmood T. Etonogestrel implant (implanon); frequency of adverse effects caused by implantation of singlerod etonogestrel implant (implanon) in females seeking birth spacing after delivery of previous pregnancy. Professional Med J. 2017; 24(5): 685-689.
5. Erfani A, Nojomi M, Hosseini H. Prolonged birth intervals in Hamedan, Iran: variations and determinants. J Biosoc Sci. 2017; 50(4): 457-471.
6. Fallahzadeh H, Farajpour Z, Emam Z. Duration and determinants of birth interval in Yazd, Iran: a population study. Iran J Reprod Med. 2013; 11(5): 379-384.
7. Abbasi-Shavazi M, Razeghi-Nasrabad HB. Patterns and factors affecting marriage to first birth interval in Iran. JPAI. 2012; 5: 75-107.
8. Torabi F, Abbasi-Shavazi MJ. Women’s education, time use and marriage in Iran. Asian Popul Stud. 2016; 12(3): 229-250.
9. McDonald P, Hosseini-Chavoshi M, Abbasi-Shavazi MJ, Rashidian A. An assessment of recent Iranian fertility trends using parity progression ratios. Demogr Res. 2015; 32: 1581-1602.
10. Saadati M, Bagheri A, Abdolahi A. Marriage to first birth interval; a cross-sectional study in Tehran (Iran). Int J Women’s Health Reprod Sci. 2018; 6(3): 290-296.
11. Bagheri A, Saadati M. Factors affecting first and second birth intervals among 15-49 year-old women in Tehran. Iran J Epidemiology. 2019; 15 (1): 68-76.
12. Saadati M, Bagheri A, Razeghi H. First birth interval and its determinants in semnan province by parametric survival model. Journal of Population Association of Iran. 2015; 10(19): 63-87.
13. Erfani, A. Fertility in Tehran city and Iran: rates, trends and differentials. Population Studies. 2013; 1(1): 87-107.
14. Erfani A, McQuillan K. The changing timing of births in Iran: an explanation on the rise and fall in fertility after the 1979 Islamic Revolution. Biodemography Soc Biol. 2014; 60(1): 1-20.
15. Erfani A. Tehran survey of fertility. Iran: National Population Studies and Comprehensive Management; 2015; 30-65.
16. Soltanian A, Davar S, Akhgar MM, Mahjub H, Karami M. Modeling the factors affecting the first birth in the family’s’ fertility in Hamedan Province. J Pharm Res Int. 2019; 28(4): 1-11.
17. Islam S. Differential determinants of birth spacing since marriage to live birth in rural Bangladesh. Pertanika J Soc Sci Hum. 2009; 17(1): 1-6.
18. Soltani Z, Eini-Zinab H, Eslami M, Motlagh M. Multivariate analysis of Iran's period fertility changes in the 1370s & 1380s. JPAI. 2018; 12(24): 171-205.
19. Amorim LDAF, Cai J. Modelling recurrent events: a tutorial for analysis in epidemiology. Int J Epidemiol. 2015; 44(1): 324-333.
20. Seyedtabib M, Moghimbeigi A, Mahmoudi M, Majdzadeh R, Mahjub H. Pattern and determinant factors of birth intervals among Iranian women: a semi-parametric multilevel survival model. J Biosoc Sci. 2020; 52(4): 534-546.
21. Statistical Center of Iran. Iran Statistical Yearbook 2016-2017. Iran; 2017; 133-179. Availble from: https://www.amar.org.ir/news/ID/5080 (20 Oct 2020).
22. Abdolahi A. Effects of socio-economic rationality dimensions on childbearing behavior in Tehran. Iran: National Population Studies and Comprehensive Management Institute, Ministry of Science, Research and Technology; 2017; 135-142.
23. Rafieian M, Shali M. The spatial analysis of Tehran’s development level based on metropolitan areas. Journal of Spatial Planning. 2013; 16(4): 25-48.
24. Abbasi-Shavazi MJ, McDonald P, Hosseini-Chavoshi M. The fertility transition in Iran. Netherlands: Springer; 2009; 75.
25. Shayan Z, Ayatollahi SMT, Zare N, Moradi F. Prognostic factors of first birth interval using the parametric survival models. Iran
 
Reprod Med. 2014; 12(2): 125-130.
26. Alam MM. Marriage to first birth interval and its associated factors in Bangladesh. Asian J Soc Sci Hum. 2015; 4(4): 36-47.
27. Begna Z, Assegid S, Kassahun W, Gerbaba M. Determinants of inter birth interval among married women living in rural pastoral communities of Southern Ethiopia: a case control study. BMC Pregnancy Childbirth. 2013; 13: 116.
28. Charmzadeh R, Akhond MR, Rasekh AR. Factors affecting women's birth intervals: the case of women referred to health centers in Ahwaz. Hayat. 2015; 20(4): 35-50.
29. Saadati M, Bagheri A. Analyzing birth interval by recurrent event models. Iran: National Population Studies and Comprehensive Management; 2018: 23-80.
30. Yadav CP, Vishnubhatla S, MA K, Pandey RM. An overview of statistical models for recurrent events analysis: a review. Epidemiology. 2018; 8(4): 1000354.
31. Thenmozhi M, Jeyaseelan V, Jeyaseelan L, Isaac R, Vedantam R. Survival analysis in longitudinal studies for recurrent events: Applications and challenges. Clin Epidemiol Glob Health. 2019; 7(2): 253-260.
32. Rasekh A, Momtaz M. The determinants of birth interval in Ahvaz- Iran: a graphical chain modelling approach. J Data Sci. 2007; 5: 555-576.
33. Keshavarz H, Haghighatiyan M, Tavasoli Dinani KH. A study on the factors influencing the space between marriage and having children (case study: married women of 20-49 in Isfahan). Journal of Applied Sociology. 2013; 24(2): 111-125.
34. Najafi-Vosough R, Soltanian AR, Fayyazi N. Influence factors on birth spacing and childbearing rates using survival recurrent events model and parity progression ratios. J Res Health Sci. 2017; 17(3): 384.