{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:01:47Z","timestamp":1787022107878,"version":"build-2736575974"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"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\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Short inter-pregnancy interval is a public health concern because it results in adverse perinatal outcomes such as postpartum hemorrhage, anemia, premature birth, low birth weight, and perinatal deaths. Although it is critical to understand the factors that contribute to short inter-pregnancy interval to reduce the risk of these negative outcomes, adequate evidence about the factors in the urban context is lacking. Therefore, we aimed to assess the duration of the inter-pregnancy interval and its predictors among pregnant women in urban South Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A community-based retrospective follow-up study was conducted among 2171 pregnant women in five geographically diverse urban settings in South Ethiopia. For the analysis, a Cox gamma shared frailty (random-effect) model was used. Adjusted hazard ratio (AHR) with a 95% CI was used to assess significant predictors. The median hazard ratio (MHR) used to report clustering effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The median duration of the inter-pregnancy interval was 22 months, 95% CI (21, 23), with an inter-quartile range of 14 months. Maternal age \u226530 years [AHR = 0.75, 95% CI: 0.58, 0.97], having no formal education [AHR = 0.60, 95% CI: 0.46, 0.78], contraceptive non-use [AHR = 2.27, 95% CI: 1.94, 2.66], breastfeeding for &lt;24 months [AHR = 4.92, 95% CI: 3.95, 6.12], death of recent child [AHR = 2.90, 95% CI: 1.41, 5.97], plan pregnancy within 24 months [AHR = 1.72, 95% CI: 1.26, 2.35], lack of discussion with husband [AHR = 1.33, 95% CI: 1.10, 1.60] and lack of husband encouragement about pregnancy spacing [AHR = 1.25, 95% CI: 1.05, 1.48] were predictors of short inter-pregnancy interval. Adjusting for predictors, the median increase in the hazard of short inter-pregnancy interval in a cluster with higher short inter-pregnancy interval is 30% [MHR = 1.30, 95% CI: 1.11, 1.43] than lower cluster.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the study settings, the duration of the inter-pregnancy interval was shorter than the World Health Organization recommendation. There is a need to improve contraceptive use and breastfeeding duration to maximize the inter-pregnancy interval. Men\u2019s involvement in reproductive health services and advocacy for women\u2019s reproductive decision-making autonomy are fundamental. The contextual disparities in the inter-pregnancy interval suggests further study and interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0271967","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T15:05:26Z","timestamp":1659366326000},"page":"e0271967","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Duration of inter-pregnancy interval and its predictors among pregnant women in urban South Ethiopia: Cox gamma shared frailty modeling"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9826-9611","authenticated-orcid":true,"given":"Belayneh Hamdela","family":"Jena","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gashaw Andargie","family":"Biks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yigzaw Kebede","family":"Gete","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kassahun Alemu","family":"Gelaye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,8,1]]},"reference":[{"key":"pone.0271967.ref001","unstructured":"World Health Organization. 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