healthy timing and spacing of pregnancy

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Healthy Timing and Spacing of Pregnancy A Prevention Strategy to Enhance the Health of Women, Infants, and Newborns. Objectives. Bring to your attention the linkage between pregnancy timing and spacing & maternal, newborn and child health outcomes Share key findings that support the linkage - PowerPoint PPT Presentation

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Healthy Timing and Spacing of Pregnancy

A Prevention Strategy to Enhance the Health of Women, Infants, and Newborns

1ObjectivesBring to your attention the linkage between pregnancy timing and spacing & maternal, newborn and child health outcomesShare key findings that support the linkagePresent key components of operationalizing HTSP2Healthy timing & spacing of pregnancy (HTSP)Previous birth spacing recommendations refer to when to give birth.HTSP is about pregnancy spacing: when to become pregnant rather than when to give birth.HTSP recommendations help women and couples make informed decision about delay and timing and spacing of pregnanciesfor the healthiest outcomes.Recommendations are evidence-based.

A frequently asked question related to HTSP is: Isnt pregnancy spacing the same as birth spacing? Yes and no. Both recommend that women space their children.

Birth spacing measures the period of time between two births. Previously, women are counseled to space their births by two years. The recommendations refer to when to give birth.

HTSP is about pregnancy spacing this is the time period between a live birth and the next pregnancy. Recommendations are evidence-based.

3The EvidenceUSAID sponsored a total of six studies: five meta analyses and SLRs, and one 17-country analysis> 190 studies; 20-30 years of data Objective: to assess the effects of pregnancy spacing on maternal and child health outcomesEvidence review by a panel of 35 WHO experts.

4One SLR & meta analysis: maternal and perinatal outcomes (77 studies; covering 30 years of data from 1966-2004)One study: miscarriage/abortion & next pregnancy outcomes (18 countries; >250,000 women whose previous pregnancy resulted in abortion)One SLR : maternal and child nutrition outcomes (33 studies; prospective, cross sectional, case control)One study in Matlab, Bangladesh: maternal, infant and child outcomes (outcomes of >150,000 pregnancies; covering 20 years of data from 1982-2002)One SLR and meta-analysis: infant and child outcomes (65 studies)One 17-country analysis of DHS findings: neonatal, infant and under-five mortality

The Studies5This is an optional slide.

Birth-to-Birth and Birth-to-Pregnancy Intervals (24 months)(9 months)BirthNext pregnancyBirthBirth-to-Pregnancy IntervalTime period between live birth and next pregnancy Birth-to-Birth IntervalTime period between two live births

DEFINITIONS: INTERVALSA 24 month birth-to-pregnancy interval is the approximate equivalent of a 33 month birth-to-birth interval. Before we go to data from the studies, let us go over the definition of intervals again.

Birth spacing or a birth-to-birth interval is the time period between two live births. Pregnancy spacing or a birth-to-pregnancy interval is the time period between a live birth and the next pregnancy.

A birth to pregnancy interval of 24 months is the approximate equivalent of a birth to birth interval of 3 years (24 months + 9 months = 33 months).

6

Pregnancy Spacing: BTP Intervals and Relative Risk of Adverse Maternal and Perinatal OutcomesSources: Conde-Agudelo, 2000, 2005; and DaVanzo et al, 2007This is data from the USAID studies. Here you see the evidence related to BTP intervals and relative risk of adverse maternal and perinatal outcomes.

The data showed that compared to longer BTP intervals of 36-47 months (reference group), risks for LBW and Pre-term Birth increase at shorter intervals starting at intervals of < 24 months - with the highest risk at BTP intervals of < 6 months

At BTP intervals of

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