{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T15:54:53Z","timestamp":1776959693825,"version":"3.51.4"},"reference-count":48,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T00:00:00Z","timestamp":1613692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Background<\/jats:title><jats:p>The World Health Organization recommended a minimum of 33 months between consecutive live births to reduce the incidence of adverse pregnancy outcomes. Poorly spaced pregnancies are associated with poor maternal and child health outcomes such as low birth weight, stillbirth, uterine rupture, neonatal mortality, maternal mortality, child malnutrition, and maternal hemorrhage. However, there was limited evidence on the duration of birth interval and its predictors among reproductive-age women in Ethiopia. Therefore, this study aimed to investigate the duration of birth interval and its predictors among reproductive-age women in Ethiopia.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>A secondary data analysis was conducted based on the 2016 Ethiopian Demographic and Health Survey data. A total weighted sample of 11022 reproductive-age women who gave birth within five years preceding the survey was included for analysis. To identify the predictors, the Gompertz gamma shared frailty model was fitted. The theta value, Akakie Information Criteria (AIC), Bayesian Information Criteria (BIC), and deviance was used for model selection. Variables with a p-value of less than 0.2 in the bi-variable analysis were considered for the multivariable analysis. In the multivariable Gompertz gamma shared frailty analysis, the Adjusted Hazard Ratio (AHR) with a 95% Confidence Interval (CI) was reported to show the strength and statistical significance of the association.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>The median inter-birth interval in Ethiopia was 38 months (95% CI: 37.58, 38.42). Being living in Addis Ababa (AHR = 0.15, 95% CI: 0.03, 0.70), being rural resident (AHR = 1.13, 95% CI: 1.01, 1.23), being Muslim religious follower (AHR = 6.53, 95% CI: 2.35, 18.18), having three birth (AHR = 0.51, 95% CI: 0.10, 0.83), having four birth (AHR = 0.30, 95% CI: 0.09, 0.74), five and above births (AHR = 0.10, 95% CI: 0.02, 0.41), and using contraceptive (AHR = 2.35, 95% CI: 1.16, 4.77) were found significant predictors of duration of birth interval.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>The length of the inter-birth interval was consistent with the World Health Organization recommendation. Therefore, health care interventions that enhance modern contraceptive utilization among women in rural areas and Muslim religious followers would be helpful to optimize birth interval.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0247091","type":"journal-article","created":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T01:39:32Z","timestamp":1613785172000},"page":"e0247091","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":29,"title":["Duration of birth interval and its predictors among reproductive-age women in Ethiopia: Gompertz gamma shared frailty modeling"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6812-1659","authenticated-orcid":true,"given":"Getayeneh Antehunegn","family":"Tesema","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Misganaw Gebrie","family":"Worku","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Achamyeleh Birhanu","family":"Teshale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,2,19]]},"reference":[{"issue":"4","key":"pone.0247091.ref001","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/j.ajog.2006.05.055","article-title":"Effects of birth spacing on maternal health: a systematic review","volume":"196","author":"A Conde-Agudelo","year":"2007","journal-title":"American journal of obstetrics and gynecology"},{"key":"pone.0247091.ref002","doi-asserted-by":"crossref","first-page":"S7","DOI":"10.1016\/j.ijgo.2004.11.012","article-title":"Effects of preceding birth intervals on neonatal, infant and under\u2010five years mortality and nutritional status in developing countries: evidence from the demographic and health surveys","volume":"89","author":"SO Rutstein","year":"2005","journal-title":"International Journal of Gynecology & Obstetrics"},{"issue":"6","key":"pone.0247091.ref003","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1017\/S0021932012000570","article-title":"Birth spacing and child mortality: an analysis of prospective data from the Nairobi urban health and demographic surveillance system","volume":"45","author":"JC Fotso","year":"2013","journal-title":"Journal of biosocial science"},{"issue":"1","key":"pone.0247091.ref004","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1186\/s12884-014-0427-6","article-title":"Determinants and consequences of short birth interval in rural Bangladesh: a cross-sectional study","volume":"14","author":"HC De Jonge","year":"2014","journal-title":"BMC pregnancy and childbirth"},{"key":"pone.0247091.ref005","unstructured":"Worldometer (www.Worldometers.info) In.; 2020."},{"issue":"1","key":"pone.0247091.ref006","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1186\/1471-2393-12-152","article-title":"Levels and correlates of non-adherence to WHO recommended inter-birth intervals in Rufiji, Tanzania","volume":"12","author":"A Exavery","year":"2012","journal-title":"BMC pregnancy and childbirth"},{"key":"pone.0247091.ref007","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1111\/j.1728-4457.2016.00134.x","article-title":"Trends in inter-birth intervals in developing countries 1965\u20132014","author":"JB Casterline","year":"2016","journal-title":"Population and Development Review"},{"issue":"S3","key":"pone.0247091.ref008","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1186\/1471-2458-13-S3-S3","article-title":"The associations of birth intervals with small-for-gestational-age, preterm, and neonatal and infant mortality: a meta-analysis.","volume":"13","author":"N Kozuki","year":"2013","journal-title":"BMC public health"},{"issue":"10018","key":"pone.0247091.ref009","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/S0140-6736(15)00837-5","article-title":"Stillbirths: rates, risk factors, and acceleration towards 2030","volume":"387","author":"JE Lawn","year":"2016","journal-title":"The Lancet"},{"issue":"1","key":"pone.0247091.ref010","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1186\/1471-2393-10-S1-S1","article-title":"Global report on preterm birth and stillbirth (1 of 7): definitions, description of the burden and opportunities to improve data","volume":"10","author":"JE Lawn","year":"2010","journal-title":"BMC pregnancy and childbirth"},{"issue":"9775","key":"pone.0247091.ref011","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1016\/S0140-6736(10)62187-3","article-title":"Committee LsSSS: Stillbirths: Where? 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