The Association of Contraceptive Use, Non-Use, and Failure with Child Health

Jocelyn E Finlay


Objective: To examine the association of contraceptive use in the interpregnancy interval with subsequent child health outcomes in low- and middle-income countries.
Design: A cross-sectional analysis of nationally representative household samples was performed. A modified Poisson regression model was used to estimate unadjusted and adjusted relative risk ratios for high prevalence outcomes.
Setting: Low- and middle-income countries.
Population: Births to women aged 12-49 years for which this birth occurred 12-79 months prior to the interview were included. The sample for analysing infant mortality was comprised of 453,795 children from 35 low- and middle-income countries across 67 Demographic and Health Surveys conducted between 1990 and 2011.
Main Outcome Measures: Infant mortality, stunting, underweight, wasting, diarrhoea, and anaemia.
Results: Contraceptive use in the interpregnancy interval, even if contraceptive failure resulted in birth, had a positive effect on all child health outcomes compared to non-use of contraception in the interpregnancy interval. The positive effect of contraceptive use was the lengthening of the interpregnancy interval, but it also had a direct positive effect on child health, independent of birth interval.
Conclusions: Extending the interval between births had a positive effect on child health outcomes, and contraceptive use had a positive effect on child health independent of the birth spacing effect. Additionally, contraceptive failure did not adversely affect child health outcomes.


Contraceptive use, birth interval, child health outcomes, Demographic and Health Surveys, infant mortality.

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ISSN: 1929-4247