Determinants and differentials of postpartum amenorrhea associated with breastfeeding among women in Bihar, India
Keywords:Postpartum amenorrhea, Breastfeeding, Kaplan–Meier, Cox-Proportional hazard, Body mass index
Background: Postpartum amenorrhea is considered to be the conception variable and its affect natural fertility by lengthening the inter-live birth interval. In societies where the fertility is not regulated through the use of contraception method there amenorrhea period can exert a dominant fertility inhibiting effect on fertility. In this paper we check differentials in duration of breastfeeding and Postpartum Amenorrhea (PPA), and to estimate mean duration of Postpartum Amenorrhea (PPA) associated with breastfeeding with influence of Scio-economic and demographic factors of ever-married woman who had given at least one but last birth in Bihar, India.
Methods: Kaplan Meier Survival method use to estimate the duration of breastfeeding and postpartum amenorrhea and multivariate Cox proportional hazard model used to measure the effect of each category of each variable on the hazard function while controlling for the effects of other variables (and their categories) included in the model.
Results: Duration of breastfeeding, parity, residence, contraceptive use have a significant impact on duration of postpartum amenorrhea (PPA) and empirical evidence indicates that longer and more frequent breastfeeding may increase the length of an ovulatory period. Mothers with a BMI greater than 18.5 kg/m2 resume ovulation faster and high mean for duration of breastfeeding than those with a lower BMI.
Conclusions: Parity, age of mothers, survival status of child and socio-economic status of mothers are found to be the main influencing factors for the timing of postpartum amenorrhea and also duration of breastfeeding among mothers., it is expected that the findings may help in designing appropriate policies and programs for improving mothers' and children's health as well as for reducing the existing fertility level of a region where contraceptive practices is low.
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