Determinants of Duration of the First Birth Interval Using the Semi-parametric Survival Model in Uttar Pradesh, India: Evidence from NFHS – 5 (2019-2021)

Udisha Singh, Jai Kishun, Anup Kumar, Uttam Singh, Sachin Kumar, Vishwas Kapoor, Prabhaker Mishra


Background: First birth is an important phenomenon in women life. It not only affects the duration of the rest of birth intervals but also affects the reproductive pattern of women. The study aims to explore the determinants of the duration of the first birth interval.
Subjects dan Method: The cross-sectional study data of 33,275 women married between the years 2005-2021 aged (15-49) years from Uttar Pradesh, were selected from NFHS-5 data. The NFHS-5 sample is a stratified two-stage sample. Socio-demographic, socio-economic and cultural factors were taken as independent variables. The dependent variable was the first birth interval variable. Data analysis was performed on SPSS version 23 software and R Programming language for graphical representation. Cox proportional hazard models were applied for analysis.
Results: The mean age of women at first marriage was 19.4; SD=3.26 years and the mean age of women at first birth was 21.39; SD=3.24 years. The median duration of the first birth interval was22 months with an IQR of 14 until 32 months. Cox hazard proportional analysis revealed that religion, residence, (ever) fetal loss, age at first birth, heard family planning, and women or husband education were found to be statistically significant factors associated with the duration of the first birth interval (p<0.001).
Conclusion: There is a need to change the mindset of people towards the concept of the use of family planning methods to increase the length of the birth interval, regardless of various factors. This would help to increase the duration of the birth interval, improve the health of women and children, as well as help reduce population growth.

Keywords: Uttar Pradesh, birth interval, semi-parametric, cox model, hazard plot.

Correspondence: Jai Kishun, Department of Biostatistics and Health Informatics, Sanjay Gandhi Postgraduate Institute of Medical Sciences. Lucknow – 226014, India; email: Mobile:

Journal of Epidemiology and Public Health (2023), 08(01): 1-14

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Abdel-Fattah M, Hifnawy T, El-Said TI, Moharam MM, Mahmoud MA (2007). Determinants of birth spacing among saudi women. J Family Community Med. 14(3): 103-111. PMID: 23012155; PMCID: PMC3410152.

Bongaarts J (2008). Fertility Transitions in Developing Countries: Progress or Stagnation?. Stud Fam Plann. 39(2): 105-110. doi: 10.1111/j.1728-4465.2008.00157.x.

Bumpass LL, Rindfuss RR, Jamosik RB (1978). Age and marital status at first birth and the pace of subsequent fertility. Demography. 15(1): 75–86. doi: 10.2307/2060491.

Chernet AG, Shebeshi DS, Banbeta A (2019). Determinant of time-to-first birth interval after marriage among Ethiopian women. BMC Women’s Health. 19(1): 1–6. doi: 10.1186/s12905-019-0858-3.

Dehesh T, Malekmohammadi N, Dehesh P (2022). Associated factors of first-birth interval among women in reproductive age, addressing maternal and child health. Reproductive Health. 19(1): 1-7. doi: 10.1186/s12978-022-01346-5.

Dommaraju P (2009). Timing of first birth in India. Genus. 65(1): 81–101.

Hoem B. (2000). Entry into motherhood in Sweden: the influence of economic factors on the rise and fall in fertility, (1986-1997). DemRes. 2(4). doi: 10.4054/demres.2000.2.4.

Joshi S, Schultz TP (2013). Family Planning and Women’s and Children’s Health: Long-Term Consequences of an Outreach Program in Matlab, Bangladesh. Demography. 50(1): 149–180. doi: 10.1007/s13524-012-0172-2.

Kamal A (2013). Determinants of Marriage to First Birth Interval in Pakistan. J Stat. 20(1): 44-68.

Khan HT, Raeside R (1998). The determinants of first and subsequent births in urban and rural areas of Bangladesh. Asia Pac Popul J. 13(2): 1-21. doi: 10.18356/961d26efen.

Kohler HP, Billari FC, Ortega JA (2002).The emergence of the low to lowest in Europe during the 1990s. Popul Dev Rev. 28(4): 641–680. doi:10.1111/j.1728-4457.2002.00641.x.

Löfstedt P, Ghilagaber G, Shusheng L, Johansson A (2005). Changes in marriage age and first birth interval in Huaning County, Yunnan Province, PR China. The Southeast Asian J Trop Med public health. 36(5): 1329–1338.

Logubayom IA, Luguterah A (2013). Survival analysis of time to first birth after marriage. Humanit Soc Sci. 3(12): 117-125.

Macinnes J (2003). Sociology and Demography: A Promising Relationship? Women's Parental Identity and Fertility in Europe. An Analysis of the Family and Gender Roles. Edimburg: Universitat d’Edimburg.

Martin SP (2000). Diverging fertility among U.S. women who delay childbearing past age 30. J Dem. 37(4): 523–533. doi: 10.2307/2648078.

Millman SR, Hendershot GE (1980). Early fertility and lifetime fertility. Fam Plann Perspect. 12(3): 139–149. doi: 10.2307/2134568.

Morgan SP, Botev N, Chen R, Huang J (1999). White and nonwhite trends in first birth timing: Comparisons using vital registration and current population surveys. Popul Res Policy Rev. doi: 10.1023/A:1006245612218.

Nath DC, Land KC, Goswami G (1999). Effects Of The Status Of Women On The First-Birth Interval In Indian Urban Society. J Biosoc Sci. 31(1): 55–69. doi: 10.1017/S0021932099000553.

NFHS (2017). National Family Health Survey (NFHS-4) 2015-16: India. Mumbai: IIPS.

NFHS (2007). National Family Health Survey (NFHS-3), 2005-06. India: Key Findings. Mumbai.

NFHS (2021). India Fact sheet (2021) Ministry of Health and Family Welfare National. Available at:

Okezie CA, Ogbe AO, Okezie CR (2010). Socio-economic determinants of contraceptive use among rural women in Ikwuano Local Government Area of Abia State, Nigeria. Int NGO J. 5(4): 74–77.

Polo V, Luna F, Fuster V (2000). Determinants of birth interval in a rural mediterranean population (La Alpujarra, Spain). Hum Biol. 72(5): 877–890.

Rasekh A, Momtaz M (2021). The Deter-minants of Birth Interval in Ahvaz-Iran: A Graphical Chain Modelling Approach. Data Sci J. 5(4): 555–576. doi: 10.6339/jds.2007.05(4).354.

Shayan Z, Ayatollahi SM, Zare N, Moradi F (2014). Prognostic factors of first birth interval using the parametric survival models. Iran J Reprod Med. 2014 Feb; 12(2):125-30. PMID: 24799870.

Simeon AA., Khalid ZM, Malaysia B (2014). Survival modelling of First Birth Interval after marriage. Life Sci J. 11(7): 299-307. ISSN: 1097-8135.

Singh OP, Singh VK, Pathak DS (2006). A Probability distribution for first birth interval. Can Stud Popul. 33(1): 69-81. doi: 10.25336/p6mw42.

Singh R, Tripathi V, Kalaivani M, Singh K, Dwivedi SN (2012a). Determinants of birth intervals in Tamil Nadu in India: Developing Cox hazard models with validations and predictions. Revista Co-lombiana de Estadística. 35(2): 289–307. ISSN 0120-1751.

Singh R, Tripathi V, Singh K, Ahuja RK, Vani MK, Dwivedi SN (2012b). Breastfeeding as a time-varying-time-dependent factor for birth spacing: multivariate models with validations and predictions. World health popul. 13(3): 28–51. doi: 10.12927/whp.2012.22857.

Suwal JV (2001). Socio-cultural dynamics of birth intervals in Nepal. Contrib Nepal Stud. 28(1): 11-33.

Trussell J, Menken J (1978). Early childbearing and subsequent fertility. Fam Plann Perspect Perspectives. 10(4): 209–218. doi: 10.9783/9781512802009-017.

Trussell J, Martin LG, Feldman R, Palmore JA, Concepcion M, Bakar DNLBDA (1985) .Determinants of birth-interval length in the Philippines, Malaysia, and Indonesia: a hazard-model Analysis. Demography. 22(2): 145–168. doi: 10.2307/2061175.

Yamaguchi K, Ferguson LR (1995). The Stopping and Spacing of Childbirths and Their Birth-History Predictors: Rational-Choice Theory and Event-History Analysis. Am Sociol Rev. 60(2): 272–298. Doi: 10.2307/2096387.

Yohannes S, Wondafrash M, Abera M, Girma E (2011). Duration and determinants of birth interval among women of child bearing age in Southern Ethiopia. BMC Pregnancy Childbirth. 11(1): 1-6. Doi: 10.1186/1471-2393-11-38.


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