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1.
Homo ; 74(1): 33-44, 2023 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-36752673

RESUMO

With the implementation of the three-child policy in China, the debate between fertility and health and longevity has again become a hot topic in the era of increasing ageing. This study aimed to explore the association between reproductive behaviour and longevity of older women and men in China. Based on data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) from 2014 to 2018, a total of 1428 deceased older people were enrolled in the study, including 421 centenarians and 1007 non-centenarians. The analysis of the association between fertility and longevity was conducted in the multivariate logistic regression. Compared to women aged 99 years and below, centenarian women had significantly fewer children (p < 0.01), fewer sons (p < 0.01) and fewer daughters. Centenarian men had more children, more daughters and fewer sons. For both men and women, centenarians were significantly characterized by later age at first birth (p < 0.01) and later age at last birth (p < 0.01). Centenarians were significantly characterized by having children and having a daughter, however, non-centenarians were significantly characterized by having a son (p < 0.01). The association between fertility and health of both men and women should be taken into account in the development of fertility policies and supporting policies. Fertility levels should be increased without compromising the health benefits of individuals in their later years.


Assuntos
Fertilidade , Longevidade , Comportamento Reprodutivo , Idoso , Feminino , Humanos , Masculino , Envelhecimento , População do Leste Asiático/estatística & dados numéricos , Comportamento Reprodutivo/estatística & dados numéricos , China/epidemiologia , Idoso de 80 Anos ou mais
2.
Med Sci Monit ; 27: e935429, 2021 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-34968369

RESUMO

BACKGROUND Women's health and undertaking health behaviors during the reproductive period by women, especially during pregnancy, are an important indicator that is reflected both in their own health and in health of their children. This study aimed to use a questionnaire to evaluate the health-related behaviors in women of reproductive age in Poland. MATERIAL AND METHODS The studies were conducted among 602 women of reproductive age by diagnostic poll method with the use of questionnaire technique. The applied tool was an original on-line questionnaire. A link to the questionnaire was sent to women aged 18-49 years using the snowball sampling technique and was posted on thematic pro-health website forums. RESULTS The majority of women participating in the study exhibited health behaviors on the average level (65.3%; M=7.6). Pro-health behaviors were exhibited mainly by women with higher education (M=7.7; SD=2.6), married women (M=8.0; SD=2.6), and women who were pregnant at the time (M=8.8; SD=2.6). However, single women participating in the study consumed alcohol more often (80.6%). The observed relationships were statistically significant (P<0.05). CONCLUSIONS This survey showed that younger women with no children were significantly less likely to be aware of positive health-associated behaviors and lifestyle when compared with older women with children. This small study supports the importance of health education in young women before they have children.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Comportamento Contraceptivo/estatística & dados numéricos , Escolaridade , Exercício Físico/estatística & dados numéricos , Comportamentos Relacionados com a Saúde , Estado Civil , Adolescente , Adulto , Feminino , Humanos , Estilo de Vida , Pessoa de Meia-Idade , Polônia , Comportamento Reprodutivo/estatística & dados numéricos , Inquéritos e Questionários , Adulto Jovem
3.
PLoS One ; 16(6): e0253736, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34191843

RESUMO

BACKGROUND: In low-income nations, high-risk fertility behavior is a prevalent public health concern that can be ascribed to unmet family planning needs, child marriage, and a weak health system. As a result, this study aimed to determine the factors that influence high-risk fertility behavior and its impact on child stunting and anemia. METHOD: This study relied on secondary data sources from recent demography and health surveys of nine east African countries. Relevant data were extracted from Kids Record (KR) files and appended for the final analysis; 31,873 mother-child pairs were included in the final analysis. The mixed-effect logistic regression model (fixed and random effects) was used to describe the determinants of high-risk fertility behavior (HRFB) and its correlation with child stunting and anemia. RESULT: According to the pooled study about 57.6% (95% CI: 57.7 to 58.2) of women had at least one high-risk fertility behavior, with major disparities found across countries and women's residences. Women who lived in rural areas, had healthcare access challenges, had a history of abortion, lived in better socio-economic conditions, and had antenatal care follow-up were more likely to engage in high-risk fertility practices. Consequently, Young maternal age at first birth (<18), narrow birth intervals, and high birth orders were HRFBs associated with an increased occurrences of child stunting and anemia. CONCLUSION: This study revealed that the magnitude of high-risk fertility behavior was higher in east Africa region. The finding of this study underscores that interventions focused on health education and behavioral change of women, and improvement of maternal healthcare access would be helpful to avert risky fertility behaviors. In brief, encouraging contraceptive utilization and creating awareness about birth spacing among reproductive-age women would be more helpful. Meanwhile, frequent nutritional screening and early intervention of children born from women who had high-risk fertility characteristics are mandatory to reduce the burden of chronic malnutrition.


Assuntos
Anemia/epidemiologia , Transtornos do Crescimento/epidemiologia , Comportamento Reprodutivo/estatística & dados numéricos , Assunção de Riscos , Adolescente , Adulto , África Oriental/epidemiologia , Fatores Etários , Intervalo entre Nascimentos/psicologia , Intervalo entre Nascimentos/estatística & dados numéricos , Ordem de Nascimento , Feminino , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos Epidemiológicos/estatística & dados numéricos , Humanos , Idade Materna , Pessoa de Meia-Idade , Estado Nutricional , Gravidez , Comportamento Reprodutivo/psicologia , Fatores de Risco , Fatores Socioeconômicos , Adulto Jovem
4.
BMC Pregnancy Childbirth ; 21(1): 444, 2021 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-34172036

RESUMO

BACKGROUND: Female sexual dysfunction (FSD) is a prevalent problem, affecting up to 41% of reproductive aged women worldwide. However, the association between female sexual function (FSF) and fecundability in women attempting to conceive remains unclear. We aimed 1) to examine the association between FSF in reproductive-aged preconception Asian women and fecundability, as measured by time-to-pregnancy in menstrual cycles, and 2) to examine lifestyle and behavioral factors associated with FSF. METHODS: From the Singapore PREconception Study of long-Term maternal and child Outcomes (S-PRESTO) prospective cohort, we evaluated FSF using the 6-item Female Sexual Function Index (FSFI-6) and ascertained time-to-pregnancy within a year of baseline assessment. We estimated fecundability ratio (FR) and 95% confidence interval (CI) using the discrete-time proportional hazards model, accounting for left-truncation and right censoring. We used multivariable logistic and linear regression models to identify potential factors related to FSF. RESULTS: Among 513 participants, 58.9% had low FSF as defined by a total FSFI-6 score at or below the median value of 22. Compared to women with high FSF, those with low FSF had a 27% reduction in fecundability (FR 0.73; 95% CI 0.54, 0.99), with adjustment for age, ethnicity, education, parity and body mass index. Overall, the FRs generally reduced with decreasing FSFI-6 scores. Physical activity, obesity, absence of probable depression and anxiety were independently associated with reduced odds of low FSF and increased FSFI-6 scores, after adjusting for sociodemographic characteristics. CONCLUSIONS: Low FSF is associated with a longer time-to-pregnancy. Early evaluation and optimization of FSF through increased physical activity and optimal mental health may help to improve female fecundity. The finding of obese women having improved FSF remains uncertain which warrants further investigations on plausibly mechanisms. In general, the current finding highlights the importance of addressing FSF in preconception care service for general women, which is currently lacking as part of the fertility promotion effort in the country.


Assuntos
Povo Asiático/estatística & dados numéricos , Fertilidade , Comportamento Reprodutivo/estatística & dados numéricos , Disfunções Sexuais Fisiológicas/epidemiologia , Tempo para Engravidar , Adulto , Feminino , Humanos , Estilo de Vida , Estudos Longitudinais , Obesidade/complicações , Obesidade/epidemiologia , Cuidado Pré-Concepcional , Gravidez , Prevalência , Modelos de Riscos Proporcionais , Estudos Prospectivos , Análise de Regressão , Fatores de Risco , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Fisiológicas/fisiopatologia , Singapura , Adulto Jovem
5.
Schizophr Bull ; 47(5): 1342-1350, 2021 08 21.
Artigo em Inglês | MEDLINE | ID: mdl-33772315

RESUMO

Nonrandom mating in parents with schizophrenia or bipolar disorder increases the population-level genetic variance among the offspring generation and creates familial (risk) environments likely to be shaped by specific conditions. The objective of this study was to investigate the occurrence of mental disorder and levels of cognitive and social functioning in individuals who have children by partners with schizophrenia or bipolar disorder compared to controls. The Danish High Risk and Resilience Study VIA 7 is a population-based cohort study conducted in Denmark between 2013 and 2016. This study focus on parents diagnosed with schizophrenia (n = 150) or bipolar disorder (n = 100) and control parents (n = 182), as well as their partners without schizophrenia or bipolar disorder (n = 440). We used linear mixed-effect models, and main outcomes were mental disorders, intelligence, processing speed, verbal working memory, and social functioning. We found that parents having children by a partner with schizophrenia or bipolar disorder more often fulfilled the criteria for a mental disorder and had poorer social functioning compared to parents having children by a partner without schizophrenia or bipolar disorder. Furthermore, parents having children by a partner with schizophrenia performed poorer on processing speed compared to parents in the control group. The presence of nonrandom mating found in this study has implications for our understanding of familial transmission of these disorders and our findings should be considered in future investigations of potential risk factors for children with a parent with schizophrenia or bipolar disorder.


Assuntos
Sintomas Comportamentais/epidemiologia , Filho de Pais Incapacitados/estatística & dados numéricos , Disfunção Cognitiva/epidemiologia , Características da Família , Predisposição Genética para Doença/epidemiologia , Transtornos Mentais/epidemiologia , Funcionamento Psicossocial , Sistema de Registros/estatística & dados numéricos , Comportamento Reprodutivo/estatística & dados numéricos , Adulto , Transtorno Bipolar/epidemiologia , Criança , Estudos de Coortes , Dinamarca/epidemiologia , Humanos , Esquizofrenia/epidemiologia
6.
J Gerontol B Psychol Sci Soc Sci ; 76(2): 348-359, 2021 01 18.
Artigo em Inglês | MEDLINE | ID: mdl-31768550

RESUMO

OBJECTIVES: No previous study to the best of our knowledge has examined the association between childlessness and health using a wide range of countries and health outcomes. This study improves previous literature by examining the relationship between "childlessness" (1 = childless for any reason, 0 = parent of biological, step, or adopted child) and health across 20 countries and five health outcomes. METHODS: Drawing on cross-sectional harmonized data from the family of Health and Retirement Surveys across the United States (HRS, Wave 11), Europe (SHARE, Waves 4 and 5), Mexico (MHAS, Wave 3), and China (CHARLS, Wave 2), we use logistic regression models to estimate the association between childlessness and poor health (poor self-rated health, 1 or more ADL limitations, 1 or more IADL limitations, 1 or more chronic conditions, and depression) in a sample of adults aged 50 and older across 20 countries (N = 109,648). RESULTS: Our results point to an absence of associations between childlessness and health, and suggest that childlessness may be associated with better (e.g., Mexico, Hungary) or worse health (e.g., Austria, Estonia, Netherlands, Poland) in certain contexts and for certain measures. DISCUSSION: We discuss these findings in light of the meaning of childlessness, as well as cross-national economic, social, and cultural contexts to provide suggestions for aging policy and future research.


Assuntos
Envelhecimento , Doença Crônica/epidemiologia , Depressão/epidemiologia , Autoavaliação Diagnóstica , Disparidades nos Níveis de Saúde , Comportamento Reprodutivo , Idoso , Envelhecimento/fisiologia , Envelhecimento/psicologia , Estudos Transversais , Cultura , Feminino , Humanos , Internacionalidade , Masculino , Comportamento Reprodutivo/psicologia , Comportamento Reprodutivo/estatística & dados numéricos , Fatores de Risco , Fatores Socioeconômicos
7.
Rheumatology (Oxford) ; 60(6): 2706-2713, 2021 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-33241288

RESUMO

OBJECTIVES: Pre-pregnancy counselling in women with systemic lupus erythematosus (SLE) is important in order to improve knowledge on the risks of pregnancy and to optimize pregnancy outcomes. Knowledge on the preferences of women with SLE regarding pre-pregnancy counselling have not yet been studied. In a closely monitored cohort of women with SLE we enquired about the present status of their wish to have children, and wish for and experiences with pre-pregnancy counselling. METHODS: A questionnaire developed by physicians in collaboration with two women with SLE was sent to all (n = 177) women participating in the Amsterdam SLE cohort. The questionnaire comprised 32 items, of which 15 focused on the above-mentioned three themes. RESULTS: A total of 124 women (70%) returned the questionnaire. The median disease duration was 13 years (interquartile range 9-19). Childlessness occurred in 51 women and 31% declared this was due to SLE [conscious decision (21%), stringent medical advice (6%), infertility due to medication (4%)]. Half of the women preferred the first pre-pregnancy counselling immediately after the SLE diagnosis (53%), together with their partner (69%). Information given by healthcare providers (81%) was preferred over information provided via brochures (35%) or the internet (26%). Pre-pregnancy face-to-face counselling from a rheumatologist and/or gynaecologist separately was preferred in 54%. CONCLUSION: One-third of women attributed their childlessness to SLE-related reasons. Pre-pregnancy counselling was preferred shortly after the onset of the disease in a non-multidisciplinary setting. The results of this study underline the importance of timely pre-conceptional counselling by healthcare providers on fertility, risks and pregnancy outcomes in women with SLE.


Assuntos
Aconselhamento/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Lúpus Eritematoso Sistêmico/psicologia , Cuidado Pré-Concepcional/métodos , Complicações na Gravidez , Feminino , Humanos , Infertilidade Feminina/induzido quimicamente , Pessoa de Meia-Idade , Países Baixos , Educação de Pacientes como Assunto/métodos , Preferência do Paciente , Cuidado Pré-Concepcional/estatística & dados numéricos , Gravidez , Resultado da Gravidez , Comportamento Reprodutivo/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos
8.
Ann N Y Acad Sci ; 1491(1): 60-73, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33258141

RESUMO

Early marriage (EM) and early childbearing (ECB) have far-reaching consequences. This study describes the prevalence, trends, inequalities, and drivers of EM and ECB in South Asia using eight rounds of Demographic and Health Survey data across 13 years. We report the percentage of ever-married women aged 20-24 years (n = 105,150) married before 18 years (EM) and with a live birth before 20 years (ECB). Relative trends were examined using average annual rate of reduction (AARR). Inequalities were examined by geography, marital household wealth, residence, and education. Sociodemographic drivers of changes for EM were assessed using regression decomposition analyses. We find that EM/ECB are still common in Bangladesh (69%/69%), Nepal (52%/51%), India (41%/39%), and Pakistan (37%/38%), with large subnational variation in most countries. EM has declined fastest in India (AARR of -3.8%/year), Pakistan (-2.8%/year), and Bangladesh (-1.5%/year), but EM elimination by 2030 will not occur at these rates. Equity analyses show that poor, uneducated women in rural areas are disproportionately burdened. Regression decomposition analysis shows that improvements in wealth and education explained 44% (India) to 96% (Nepal) of the actual EM reduction. Investments across multiple sectors are required to understand and address EM and ECB, which are pervasive social determinants of maternal and child wellbeing.


Assuntos
Saúde da Criança/estatística & dados numéricos , Casamento/estatística & dados numéricos , Comportamento Reprodutivo/estatística & dados numéricos , Adolescente , Bangladesh , Países em Desenvolvimento , Escolaridade , Feminino , Humanos , Índia , Nepal , Paquistão , Fatores Socioeconômicos , Adulto Jovem
9.
Reprod Biomed Online ; 42(2): 442-450, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33246804

RESUMO

RESEARCH QUESTION: To examine the motivations, life circumstances and parenthood aspirations of a cohort of women who underwent planned oocyte cryopreservation (POC) at a Canadian academic IVF centre. DESIGN: A single-site, cross-sectional, anonymous quantitative study using a study-specific questionnaire administrated via SurveyMonkey®. Of the 224 women who completed at least one POC cycle between 2012 and 2018, 198 were reached by email and invited to participate. RESULTS: Of the 98 (49.5%) questionnaires returned, 86 were fully completed and were analysed. Mean age at first POC cycle was 35.7 ± 2.4 (range 27-43) and at survey was 37.7 ± 2.5 years. At POC, 77% were single and 97.7% childless. At survey, 96% had not attempted to use their cryopreserved oocytes, yet 26 (30%) had tried natural conception or fertility treatments. Of these, three conceived naturally and two by assisted reproduction. Eighty-five per cent expressed a strong motherhood desire and 67.1% indicated that usage of their cryopreserved oocytes was mostly contingent on relationship status. Many expressed a desire for shared genetic parenthood within a committed relationship. Forty-seven per cent did not want to carry a pregnancy beyond the age of 46. CONCLUSION: The findings of this study confirm the central role of age and relationship status in influencing women's POC decisions and oocyte utilization plans. The late age at POC could be explained by women using it toward the end of their peak reproductive years to leverage their remaining chances of genetic motherhood. Surveying women at later points following POC would help to gain a more comprehensive picture of their oocyte utilization and disposition plans.


Assuntos
Criopreservação , Preservação da Fertilidade/psicologia , Idade Materna , Oócitos , Comportamento Reprodutivo/psicologia , Adulto , Estudos Transversais , Feminino , Preservação da Fertilidade/estatística & dados numéricos , Humanos , Pessoa de Meia-Idade , Comportamento Reprodutivo/estatística & dados numéricos
10.
Demography ; 57(6): 1975-2001, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33179200

RESUMO

In the United States, underachieving fertility desires is more common among women with higher levels of education and those who delay first marriage beyond their mid-20s. However, the relationship between these patterns, and particularly the degree to which marriage postponement explains lower fertility among the highly educated, is not well understood. We use data from the National Longitudinal Survey of Youth 1979 cohort to analyze differences in parenthood and achieved parity for men and women, focusing on the role of marriage timing in achieving fertility goals over the life course. We expand on previous research by distinguishing between entry into parenthood and average parity among parents as pathways to underachieving, by considering variation in the impact of marriage timing by education and by stage of the life course, and by comparing results for men and women. We find that women with a bachelor's degree who desired three or more children are less likely to become mothers relative to women with the same desired family size who did not attend college. Conditional on becoming mothers, however, women with at least a bachelor's degree do not have lower completed family size. No comparable fatherhood difference by desired family size is present. Postponing marriage beyond age 30 is associated with lower proportions of parenthood but not with lower parity among parents. Age patterns are similar for women and men, pointing at social rather than biological factors driving the underachievement of fertility goals.


Assuntos
Escolaridade , Características da Família , Casamento/estatística & dados numéricos , Pais , Comportamento Reprodutivo/estatística & dados numéricos , Adulto , Fatores Etários , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Estados Unidos
11.
Demography ; 57(6): 2035-2045, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33169340

RESUMO

The U.S. period total fertility rate has declined steadily since the Great Recession, reaching 1.73 children in 2018, the lowest level since the 1970s. This pattern could mean that current childbearing cohorts will end up with fewer children than previous cohorts, or this same pattern could be an artifact of a tempo distortion if individuals are simply postponing births they plan to eventually have. In this research note, we use data on current parity and future intended births from the 2006-2017 National Survey of Family Growth to shed light on this issue. We find that total intended parity declined (from 2.26 in 2006-2010 to 2.16 children in 2013-2017), and the proportion intending to remain childless increased slightly. Decomposition indicates that the decline was not due to changes in population composition but rather changes in the subgroups' rates themselves. The decline in intended parity is particularly notable at young ages and among those who are Hispanic. These results indicate that although tempo distortion is likely an important contributor to the decline in TFR, it is not the sole explanation: U.S. individuals are intending to have fewer children than their immediate predecessors, which may translate into a decline in cohort completed parity. However, the change in intended parity is modest, and average intended parity remains above two children.


Assuntos
Características da Família , Comportamento Reprodutivo/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Escolaridade , Feminino , Humanos , Intenção , Masculino , Paridade , Grupos Raciais , Estados Unidos , Adulto Jovem
12.
PLoS One ; 15(11): e0241610, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33253173

RESUMO

INTRODUCTION: This study aimed to assess the prevalence, sociodemographic factors, reproductive consequences, and heritable disease burdens associated with consanguineous marriage (CM) in Bangladesh. METHODS: A total of 7,312 families, including 3,694 CM-families, were recruited from 102 locales of 58 districts of Bangladesh. Using a standard questionnaire, we collected medical history and background sociodemographic data of these families. Family history was assessed by pedigree analysis. Fertility, mortality, secondary sex ratio, selection intensity, lethal equivalents were measured using standard methods. RESULTS: The mean prevalence of CM in our studied population was 6.64%. Gross fertility was higher among CM families, as compared to the non-CM families (p < 0.05). The rate of under-5 child (U5) mortality was significantly higher among CM families (16.6%) in comparison with the non-CM families (5.8%) (p < 0.01). We observed a persuasive rise of abortion/miscarriage and U5 mortality rates with the increasing level of inbreeding. The value of lethal equivalents per gamete found elevated for autosomal inheritances as compared to sex-linked inheritance. CM was associated with the incidence of several single-gene and multifactorial diseases, and congenital malformations, including bronchial asthma, hearing defect, heart diseases, sickle cell anemia (p < 0.05). The general attitude and perception toward CM were rather indifferent, and very few people were concerned about its genetic burden. CONCLUSION: This study highlights the harmful consequences of CM on reproductive behavior and the incidence of hereditary conditions. It essences the need for genetic counseling from premarital to postnatal levels in Bangladesh.


Assuntos
Anormalidades Congênitas/epidemiologia , Consanguinidade , Doenças Genéticas Inatas/epidemiologia , População/genética , Comportamento Reprodutivo/estatística & dados numéricos , Adulto , Bangladesh , Criança , Anormalidades Congênitas/genética , Feminino , Doenças Genéticas Inatas/genética , Humanos , Masculino , Mortalidade/tendências , Herança Multifatorial , Linhagem , Seleção Genética
13.
Gastroenterol Clin North Am ; 49(4): 769-789, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33121695

RESUMO

Although ulcerative colitis affects males and females at similar rates, certain sex-specific differences influence the disease-related risks and experiences of females with ulcerative colitis. This article reviews topics that affect females with ulcerative colitis, including the impact of disease on the menstrual cycle, fertility, child bearing, sexual health, and recommendations for health care maintenance.


Assuntos
Colite Ulcerativa/fisiopatologia , Colite Ulcerativa/psicologia , Ciclo Menstrual , Saúde Sexual , Saúde da Mulher , Colite Ulcerativa/complicações , Diarreia/etiologia , Feminino , Fertilidade , Humanos , Osteoporose/etiologia , Osteoporose/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Gravidez , Comportamento Reprodutivo/estatística & dados numéricos , Risco , Neoplasias do Colo do Útero/etiologia , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/virologia
14.
Demography ; 57(6): 2047-2056, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33001419

RESUMO

Persistently high levels of unintended fertility, combined with evidence that over- and underachieved fertility are typical and not exceptional, have prompted researchers to question the utility of fertility desires writ large. In this study, we elaborate this paradox: widespread unintendedness and meaningful, highly predictive fertility desires can and do coexist. Using data from Malawi, we demonstrate the predictive validity of numeric fertility timing desires over both four-month and one-year periods. We find that fertility timing desires are highly predictive of pregnancy and that they follow a gradient wherein the likelihood of pregnancy decreases in correspondence with desired time to next birth. This finding holds despite the simultaneous observation of high levels of unintended pregnancy in our sample. Discordance between desires and behaviors reflects constraints to achieving one's fertility and the fluidity of desires but not their irrelevance. Fertility desires remain an essential-if sometimes blunt-tool in the demographers' toolkit.


Assuntos
Intervalo entre Nascimentos/psicologia , Comportamento Reprodutivo/estatística & dados numéricos , Adolescente , Adulto , Escolaridade , Características da Família , Feminino , Humanos , Entrevistas como Assunto , Estudos Longitudinais , Malaui , Casamento , Gravidez , Gravidez não Planejada , Adulto Jovem
15.
Folia Med (Plovdiv) ; 62(3): 477-481, 2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-33009742

RESUMO

INTRODUCTION: A socio-demographic analysis of marriage and family requires conducting deep studies penetrating the essence of the processes among the population. The issue of birth-rate, as a basic factor that determines the reproduction of the population, takes a central position in the demographic studies. The study of the influence of the mothers' reproductive behaviour on their daughters' repro-ductive attitude is of an undisputed interest. This study deals with mothers' realized plans as a factor in their daughters' family planning. MATERIALS AND METHODS: This cross-sectional study was carried out in 2018 through a direct group anonymous inquiry among 395 female students. The statistical processing of the data was made with descriptive, alternative, correlation and variance analyses. RESULTS: The students' reproductive behaviour is statistically significantly dependent on their mothers' realized family plans. Moth-ers' education and the real number of children are statistically significant factors for their daughters' views about the ideal and planned number of children. CONCLUSION: This study of the reproductive behaviour of the students advances the knowledge in the field by revealing that it is statisti-cally significantly dependent on their mothers' realized plans.


Assuntos
Mães/estatística & dados numéricos , Núcleo Familiar/psicologia , Comportamento Reprodutivo , Estudantes de Ciências da Saúde , Adolescente , Adulto , Bulgária , Estudos Transversais , Escolaridade , Serviços de Planejamento Familiar , Feminino , Humanos , Comportamento Reprodutivo/psicologia , Comportamento Reprodutivo/estatística & dados numéricos , Estudantes de Ciências da Saúde/psicologia , Estudantes de Ciências da Saúde/estatística & dados numéricos , Adulto Jovem
16.
Demography ; 57(6): 2113-2141, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33067758

RESUMO

Changes in fertility patterns are hypothesized to be among the many second-order consequences of armed conflict, but expectations about the direction of such effects are theoretically ambiguous. Prior research, from a range of contexts, has also yielded inconsistent results. We contribute to this debate by using harmonized data and methods to examine the effects of exposure to conflict on preferred and observed fertility outcomes across a spatially and temporally extensive population. We use high-resolution georeferenced data from 25 sub-Saharan African countries, combining records of violent events from the Armed Conflict Location and Event Data Project (ACLED) with data on fertility goals and outcomes from the Demographic and Health Surveys (n = 368,765 women aged 15-49 years). We estimate a series of linear and logistic regression models to assess the effects of exposure to conflict events on ideal family size and the probability of childbearing within the 12 months prior to the interview. We find that, on average, exposure to armed conflict leads to modest reductions in both respondents' preferred family size and their probability of recent childbearing. Many of these effects are heterogeneous between demographic groups and across contexts, which suggests systematic differences in women's vulnerability or preferred responses to armed conflict. Additional analyses suggest that conflict-related fertility declines may be driven by delays or reductions in marriage. These results contribute new evidence about the demographic effects of conflict and their underlying mechanisms, and broadly underline the importance of studying the second-order effects of organized violence on vulnerable populations.


Assuntos
Conflitos Armados/estatística & dados numéricos , Países em Desenvolvimento/estatística & dados numéricos , Comportamento Reprodutivo/estatística & dados numéricos , Adolescente , Adulto , África Subsaariana/epidemiologia , Compostos Aza , Feminino , Compostos Heterocíclicos de 4 ou mais Anéis , Humanos , Intenção , Pessoa de Meia-Idade , Fatores Socioeconômicos , Adulto Jovem
17.
Demography ; 57(6): 2169-2198, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32935302

RESUMO

Although the associations among marital status, fertility, bereavement, and adult mortality have been widely studied, much less is known about these associations in polygamous households, which remain prevalent across much of the world. We use data from the Utah Population Database on 110,890 women and 106,979 men born up to 1900, with mortality follow-up into the twentieth century. We examine how the number of wife deaths affects male mortality in polygamous marriages, how sister wife deaths affect female mortality in polygamous marriages relative to the death of a husband, and how marriage order affects the mortality of women in polygamous marriages. We also examine how the number of children ever born and child deaths affect the mortality of men and women as well as variation across monogamous and polygamous unions. Our analyses of women show that the death of a husband and the death of a sister wife have similar effects on mortality. Marriage order does not play a role in the mortality of women in polygamous marriages. For men, the death of one wife in a polygamous marriage increases mortality to a lesser extent than it does for men in monogamous marriages. For polygamous men, losing additional wives has a dose-response effect. Both child deaths and lower fertility are associated with higher mortality. We consistently find that the presence of other kin in the household-whether a second wife, a sister wife, or children-mitigates the negative effects of bereavement.


Assuntos
Luto , Características da Família , Casamento/estatística & dados numéricos , Mortalidade/tendências , Comportamento Reprodutivo/estatística & dados numéricos , Igreja de Jesus Cristo dos Santos dos Últimos Dias , Feminino , Humanos , Masculino , Paridade , Fatores Sexuais , Fatores Socioeconômicos , Utah , Viuvez/estatística & dados numéricos
18.
Demography ; 57(5): 1647-1680, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32875482

RESUMO

Zika virus epidemics have potential large-scale population effects. Controlled studies of mice and nonhuman primates indicate that Zika affects fecundity, raising concerns about miscarriage in human populations. In regions of Brazil, Zika risk peaked months before residents learned about the epidemic and its relation to congenital anomalies. This spatiotemporal variation supports analysis of both biological effects of Zika infection on fertility and the effects of learning about Zika risk on reproductive behavior. Causal inference techniques used with vital statistics indicate that the epidemic caused reductions in birth cohort size of approximately one-quarter 18 months after Zika infection risk peaked but 10 months after public health messages advocated childbearing delay. The evidence is consistent with small but not statistically detectable biological reductions in fecundity, as well as large strategic changes in reproductive behavior to temporally align childbearing with reduced risk to infant health. The behavioral effects are larger for more-educated and older women, which may reflect facilitated access to information and to family planning services within high-risk, mosquito-infested urban locations as well as perceptions about the opportunity costs of risks to pregnancy and infant survival.


Assuntos
Complicações Infecciosas na Gravidez/epidemiologia , Comportamento Reprodutivo/estatística & dados numéricos , Infecção por Zika virus/epidemiologia , Adulto , Fatores Etários , Brasil/epidemiologia , Epidemias , Feminino , Humanos , Microcefalia/epidemiologia , Gravidez , Características de Residência , Fatores Socioeconômicos , Adulto Jovem
19.
PLoS One ; 15(9): e0236712, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915798

RESUMO

INTRODUCTION: The Reproductive Life Plan (RLP) is a clinical tool to help clients find strategies to achieve their reproductive goals. Despite much research on the RLP from high-income countries, it has never been studied in low- or middle income countries. Together with health workers called Mentor Mothers (MMs), we used a context-adapted RLP in disadvantaged areas in Eswatini. Our aim was to evaluate the implementation of the RLP in this setting. METHODOLOGY: MMs participated in focus group discussions (FGDs, n = 3 MMs n = 29) in January 2018 and at follow-up in May 2018 (n = 4, MMs n = 24). FGDs covered challenges in using the RLP, how to adapt it, and later experiences from using it. We used a deductive qualitative thematic analysis with the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, creating themes guided by its four constructs: facilitation, innovation, recipients and context. The MMs also answered a questionnaire to assess the implementation process inspired by normalization process theory. RESULTS: The RLP intervention was feasible and acceptable among MMs and fit well with existing practices. The RLP questions were perceived as advantageous since they opened up discussions with clients and enabled reflection. All except one MM (n = 23) agreed or strongly agreed that they valued the effect the RLP has had on their work. Using the RLP, the MMs observed progress in pregnancy planning among their clients and thought it improved the quality of contraceptive counselling. The clients' ability to form and achieve their reproductive goals was hampered by contextual factors such as intimate partner violence and women's limited reproductive health and rights. DISCUSSION: The RLP was easily implemented in these disadvantaged communities and the MMs were key persons in this intervention. The RLP should be further evaluated among clients and suitable approaches to include partners are required.


Assuntos
Implementação de Plano de Saúde/normas , Avaliação de Programas e Projetos de Saúde , Educação Sexual/métodos , Adulto , Essuatíni , Feminino , Implementação de Plano de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Comportamento Reprodutivo/psicologia , Comportamento Reprodutivo/estatística & dados numéricos , Educação Sexual/normas , Inquéritos e Questionários , Populações Vulneráveis
20.
PLoS One ; 15(8): e0237794, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32845930

RESUMO

AIMS: This study explores the differences in sickness absence trends in women according to reproductive age group and medical diagnoses. METHODS: Data were obtained from two administrative registries: the Continuous Working Life Sample and the Catalonian Institute of Medical Evaluations from 2012 to 2014, containing 47,879 female employees. Incidence rates and incidence risk ratios derived from Poisson and negative binomial models were calculated to compare sickness absence trends among reproductive age groups based on Catalonian birthrates: early-reproductive (25-34 years old), middle-reproductive (35-44) and late-reproductive (45-54), according to diagnostic groups, selected diseases, type of contract, occupational category, and country of origin. RESULTS: Younger women show a higher incidence of overall sickness absence compared to late-reproductive-aged women. Incidence risk ratios of sickness absence decreased significantly from early-reproductive to late-reproductive age for low back pain, hemorrhage in early pregnancy, nausea and vomiting, and abdominal and pelvic pain. DISCUSSION: The higher incidence of sickness absence due to pregnancy-related health conditions in early-reproductive women compared to other reproductive age groups, may explain the sickness absence differences by age in women. Proper management of sickness absence related to pregnancy should be a goal to reduce the sickness absence gap between younger and older women.


Assuntos
Coeficiente de Natalidade , Complicações na Gravidez/epidemiologia , Comportamento Reprodutivo/estatística & dados numéricos , Licença Médica/estatística & dados numéricos , Adulto , Fatores Etários , Estudos de Coortes , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Gravidez , Sistema de Registros/estatística & dados numéricos , Espanha
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