{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T18:08:09Z","timestamp":1789063689962,"version":"build-2803163510"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosglobalpublichealth.org"],"crossmark-restriction":false},"short-container-title":["PLOS Glob Public Health"],"abstract":"<jats:p>Short inter-birth intervals may increase maternal psychological stress and have been hypothesized to contribute to depressive symptoms. We assessed the association between recent birth spacing and depression in mothers in Karachi, Pakistan. We conducted a cross-sectional, interviewer-administered survey of mothers recruited via convenience sampling from public parks and shopping malls in Karachi. Eligible participants were mothers with \u22652 children who had delivered within the past five years; women who were currently pregnant or &lt;2 months postpartum were excluded. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9); the primary outcome was PHQ-9\u2009\u2265\u200910. Birth spacing was calculated as the interval between the two most recent live births and categorized as &lt;24 months, 24\u201332 months, and \u226533 months (reference). We used logistic regression to estimate crude and adjusted odds ratios (aOR), adjusting for maternal age, education (formal vs none), number of children (2 vs\u2009\u2265\u20093), and household income (&lt;50,000 vs\u2009\u2265\u200950,000 PKR). Of 202 completed questionnaires, 15 were excluded due to missing key exposure data, leaving 187 mothers for analysis; adjusted models included 181 participants. Overall, 37\/187 (19.8%) screened positive for probable depression (PHQ-9\u2009\u2265\u200910). Compared with spacing \u226533 months, the adjusted odds of PHQ-9\u2009\u2265\u200910 were aOR 2.39, 95% CI 0.84\u20136.75 for spacing 24\u201332 months, and aOR 2.17, 95% CI 0.79\u20135.96 for &lt;24 months. No formal education was associated with higher odds of PHQ-9\u2009\u2265\u200910 (aOR 4.62, 95% CI 1.50\u201314.20). In this sample of mothers in Karachi, shorter birth spacing was not significantly associated with higher odds of probable depression. Larger, probability-based studies are needed to clarify the relationship between birth spacing and depression.<\/jats:p>","DOI":"10.1371\/journal.pgph.0007190","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T17:31:56Z","timestamp":1789061516000},"page":"e0007190","update-policy":"https:\/\/doi.org\/10.1371\/journal.pgph.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["The relationship between reduced child spacing and depression in mothers: A cross-sectional study in Karachi, Pakistan"],"prefix":"10.1371","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9919-0873","authenticated-orcid":true,"given":"Syed Abbas Moazzam","family":"Kazmi","sequence":"first","affiliation":[{"name":"Medical College, The Aga Khan University","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4869-7201","authenticated-orcid":true,"given":"Muhammad Mushahid Hussain","family":"Rizvi","sequence":"additional","affiliation":[{"name":"Medical College, The Aga Khan University","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameen","family":"Nasir","sequence":"additional","affiliation":[{"name":"Medical College, The Aga Khan University","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahnoor","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Medical College, The Aga Khan University","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hawra","family":"Hussain","sequence":"additional","affiliation":[{"name":"Medical College, The Aga Khan University","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haleema","family":"Sadia","sequence":"additional","affiliation":[{"name":"Medical College, The Aga Khan University","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayesha","family":"Siddiq","sequence":"additional","affiliation":[{"name":"Medical College, The Aga Khan University","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleena","family":"Asif","sequence":"additional","affiliation":[{"name":"Medical College, The Aga Khan University","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4839-6943","authenticated-orcid":true,"given":"Maham","family":"Jaskani","sequence":"additional","affiliation":[{"name":"Medical College, The Aga Khan University","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8095-3618","authenticated-orcid":true,"given":"Zulfiqar","family":"Jogezai","sequence":"additional","affiliation":[{"name":"Medical College, The Aga Khan University","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor us","family":"Sabahat","sequence":"additional","affiliation":[{"name":"Medical College, The Aga Khan University","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8033-3487","authenticated-orcid":true,"given":"Abdul Basit","family":"Afzal","sequence":"additional","affiliation":[{"name":"Medical College, The Aga Khan University","place":["Karachi, Pakistan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8174-1625","authenticated-orcid":true,"given":"Asaad Ahmed","family":"Nafees","sequence":"additional","affiliation":[{"name":"The Aga Khan University","place":["Karachi, Pakistan"],"department":["Department of Community Health 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