{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:36:07Z","timestamp":1792031767013,"version":"4.4.0"},"reference-count":35,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,12,12]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the effect of short (&lt;36 months) and long (\u226560 months) birth intervals on adverse pregnancy outcomes in Bangladesh.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting and participants<\/jats:title>\n                    <jats:p>We analysed data from six Bangladesh Demographic and Health Surveys (1996\u20131997, 1999\u20132000, 2004, 2007, 2011 and 2014). We included all singleton non-first live births, most recently born to mothers within 5\u2009years preceding each survey (n=21\u2009382). We defined birth interval according to previous research which suggests that a birth interval between 36 and 59 months is the most ideal interval. Bivariate and multivariable analyses were conducted to obtain the crude and adjusted ORs (aOR) respectively to assess the odds of first-day neonatal death, early neonatal death and small birth size for both short (&lt;36 months) and long (\u226560 months) spacing between births.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>First-day neonatal death, early neonatal death and small birth size.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the multivariable analysis, compared with births spaced 36\u201359 months, infants with a birth interval of &lt;36 months had increased odds of first-day neonatal death (aOR: 2.11, 95%\u2009CI: 1.17 to 3.78) and early neonatal death (aOR: 1.58, 95%\u2009CI: 1.13 to 2.22). Compared with births spaced 36\u201359 months, infants with a birth interval of \u226560 months had increased odds of first-day neonatal death (aOR: 2.02, 95%\u2009CI: 1.10 to 3.73) and small birth size (aOR: 1.17, 95%\u2009CI: 1.02 to 1.34). When there was a history of any previous pregnancy loss, there was an increase in the odds of first-day and early neonatal death for both short and long birth intervals, although it was not significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Birth intervals shorter than 36 months and longer than 59 months are associated with increased odds of adverse pregnancy outcomes. Care-providers, programme managers and policymakers could focus on promoting an optimal birth interval between 36 and 59 months in postpartum family planning.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-024392","type":"journal-article","created":{"date-parts":[[2019,2,23]],"date-time":"2019-02-23T05:15:23Z","timestamp":1550898923000},"page":"e024392","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Risk of adverse pregnancy outcomes associated with short and long birth intervals in Bangladesh: evidence from six Bangladesh Demographic and Health Surveys, 1996\u20132014"],"prefix":"10.1136","volume":"9","author":[{"given":"Monjura Khatun","family":"Nisha","sequence":"first","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraful","family":"Alam","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Tajul","family":"Islam","sequence":"additional","affiliation":[{"name":"Save the Children Bangladesh, Dhaka, Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanvir","family":"Huda","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"Raynes-Greenow","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,2,22]]},"reference":[{"key":"2025121400493819000_9.2.e024392.1","doi-asserted-by":"crossref","first-page":"e98","DOI":"10.1016\/S2214-109X(15)00275-2","article-title":"National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis","volume":"4","author":"Blencowe","year":"2016","journal-title":"Lancet Glob Health"},{"key":"2025121400493819000_9.2.e024392.2","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1016\/S0140-6736(14)61698-6","article-title":"Global, regional, and national causes of child mortality in 2000\u201313, with projections to inform post-2015 priorities: an updated systematic analysis","volume":"385","author":"Liu","year":"2015","journal-title":"The Lancet"},{"key":"2025121400493819000_9.2.e024392.3","unstructured":"World Health Organization. Newborns: reducing mortality. 2017 http:\/\/www.who.int\/mediacentre\/factsheets\/fs333\/en\/ (Accessed 17 Nov 2017)."},{"key":"2025121400493819000_9.2.e024392.4","unstructured":"United Nations Children\u2019s Fund and World Health Organization. 2004. Low Birth Weight: Country, regional and global estimates: UNICEF, New York."},{"key":"2025121400493819000_9.2.e024392.5","unstructured":"World Health Organization. Care of the preterm and low-birth-weight newborn. 2017. http:\/\/www.who.int\/maternal_child_adolescent\/newborns\/prematurity\/en\/ (12 Dec 2017)."},{"key":"2025121400493819000_9.2.e024392.6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.15.1809"},{"key":"2025121400493819000_9.2.e024392.7","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1111\/jog.12783","article-title":"Impact of interpregnancy interval on the subsequent risk of adverse perinatal outcomes","volume":"41","author":"Ekin","year":"2015","journal-title":"J Obstet Gynaecol Res"},{"key":"2025121400493819000_9.2.e024392.8","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1111\/birt.12289","article-title":"A first look at the effects of long inter-pregnancy interval and advanced maternal age on perinatal outcomes: A retrospective cohort study","volume":"44","author":"Qin","year":"2017","journal-title":"Birth"},{"key":"2025121400493819000_9.2.e024392.9","unstructured":"World Health Organization. Report of a WHO Technical consultation on birth spacing. 2005."},{"key":"2025121400493819000_9.2.e024392.10","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-12-152"},{"key":"2025121400493819000_9.2.e024392.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2004.11.012"},{"key":"2025121400493819000_9.2.e024392.12","unstructured":"National Institute of Population Research and Training (NIPORT) MaA, and ICF International. Bangladesh Demographic and Health Survey 2014. Dhaka, Bangladesh, and Rockville, Maryland, USA: NIPORT, Mitra and Associates, and ICF International, 2016."},{"key":"2025121400493819000_9.2.e024392.13","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1186\/s12889-016-3577-9","article-title":"Trend of determinants of birth interval dynamics in Bangladesh","volume":"16","author":"Khan","year":"2016","journal-title":"BMC Public Health"},{"key":"2025121400493819000_9.2.e024392.14","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1080\/00324720802022089","article-title":"The effects of pregnancy spacing on infant and child mortality in Matlab, Bangladesh: how they vary by the type of pregnancy outcome that began the interval","volume":"62","author":"DaVanzo","year":"2008","journal-title":"Popul Stud"},{"key":"2025121400493819000_9.2.e024392.15","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-014-0427-6"},{"key":"2025121400493819000_9.2.e024392.16","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dys184"},{"key":"2025121400493819000_9.2.e024392.17","unstructured":"Rutstein SO . Further evidence of the effects of preceding birth intervals on neonatal, infant, and under-five-years mortality and nutritional status in developing countries: evidence from the demographic and health surveys. DHS Working Papers No 41. Calverton, Maryland, USA: Macro International, 2008."},{"key":"2025121400493819000_9.2.e024392.18","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2014-006722","article-title":"Risk factors for under-5 mortality: evidence from Bangladesh Demographic and Health Survey, 2004-2011","volume":"5","author":"Abir","year":"2015","journal-title":"BMJ Open"},{"key":"2025121400493819000_9.2.e024392.19","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2016-013350","article-title":"Trends and population-attributable risk estimates for predictors of early neonatal mortality in Nigeria, 2003-2013: a cross-sectional analysis","volume":"7","author":"Ezeh","year":"2017","journal-title":"BMJ Open"},{"key":"2025121400493819000_9.2.e024392.20","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0181332","article-title":"Socio-economic predictors of stillbirths in Nepal (2001-2011)","volume":"12","author":"Ghimire","year":"2017","journal-title":"PLoS One"},{"key":"2025121400493819000_9.2.e024392.21","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1186\/s12884-016-0929-5","article-title":"Effect of interpregnancy interval on adverse pregnancy outcomes in northern Tanzania: a registry-based retrospective cohort study","volume":"16","author":"Mahande","year":"2016","journal-title":"BMC Pregnancy Childbirth"},{"key":"2025121400493819000_9.2.e024392.22","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/fmn027"},{"key":"2025121400493819000_9.2.e024392.23","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-13-S3-S6"},{"key":"2025121400493819000_9.2.e024392.24","doi-asserted-by":"crossref","first-page":"2640","DOI":"10.1080\/14767058.2016.1260115","article-title":"Inter-pregnancy interval and adverse outcomes: Evidence for an additional risk in health disparate populations","volume":"30","author":"Appareddy","year":"2017","journal-title":"J Matern Fetal Neonatal Med"},{"key":"2025121400493819000_9.2.e024392.25","doi-asserted-by":"publisher","DOI":"10.2307\/2135451"},{"key":"2025121400493819000_9.2.e024392.26","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.82.5.691"},{"key":"2025121400493819000_9.2.e024392.27","doi-asserted-by":"crossref","first-page":"1732S","DOI":"10.1093\/jn\/133.5.1732S","article-title":"The risk of maternal nutritional depletion and poor outcomes increases in early or closely spaced pregnancies","volume":"133","author":"King","year":"2003","journal-title":"J Nutr"},{"key":"2025121400493819000_9.2.e024392.28","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)07105-7"},{"key":"2025121400493819000_9.2.e024392.29","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199902253400809"},{"key":"2025121400493819000_9.2.e024392.30","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2012.01285.x"},{"key":"2025121400493819000_9.2.e024392.31","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000171118.79529.a3"},{"key":"2025121400493819000_9.2.e024392.32","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000286759.49895.46"},{"key":"2025121400493819000_9.2.e024392.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2004.08.002"},{"key":"2025121400493819000_9.2.e024392.34","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199902253400801"},{"key":"2025121400493819000_9.2.e024392.35","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1080\/00324728.2011.602100","article-title":"Infant death clustering in families: magnitude, causes, and the influence of better health services, Bangladesh 1982-2005","volume":"65","author":"Saha","year":"2011","journal-title":"Popul Stud"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-024392","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T08:49:46Z","timestamp":1765702186000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-024392"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2]]},"references-count":35,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,2,22]]},"published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1136\/bmjopen-2018-024392"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-024392","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2]]}}}