Influence Factors on Birth Spacing and Childbearing Rates using Survival Recurrent Events Model and Parity Progression Ratios

Background: Reproduction rates are declining in Hamadan, western Iran. This study identified the influence factors associated with reproduction rate and birth spacing in Hamadan as an area of low population growth in Iran. Study design: A cross sectional study. Methods: The study considered reproductive status of 812 women referred to health care centers of Hamadan, western Iran in 2015. Data were obtained through frequency and percentage. PWP-GT model was used to determine the influence factors on women's reproductive by R software (version 3.3.2). The parity progression ratios were determined based on Yadava and Kumar. Results: The median time for the second, the third and the fourth birth was 4.53, 4.65 and 5.27 yr, respectively. PWP-GT model showed that women age at marriage (P=0.001), women's (P=0.005) and their husband's (P=0.039) employment had significant effect on time birth of first child. The women's education (P=0.001) was the only variable that had a significant effect on the birth time from the first to the second child as well as from the third to the fourth child. Education of women (P=0.001) and their husbands (P=0.034) had significant effect on the time interval from the second to the third child. The birth probability from marriage to the first birth (0 to 1st child) was high (0.91), while the probability had been fallen from the third birth and more (0.31). Conclusions: Birth spacing in Hamadan is more than WHO recommended. In addition, reducing of the population growth and childbearing has started in the past few decades in Hamadan the same as Iran. The chance of fertility has dramatically declined from the third child and then.