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Purpose: The improvement of clinical outcome provided by time-lapse technology (TLT) in IVF over conventional incubation (CI) still remains controversial. This study aimed at evaluating whether the exclusive use of time-lapse technology (TLT) during whole IVF care improves total cumulative live birth rate (TCLBR) and shortens time to live birth (TTLB) as compared to the use of CI in couples undergoing ICSI. Methods: This retrospective cohort study was conducted in couples with male infertility undergoing their first ICSI cycle in 2014–2015 and for whom embryo culture system remained the same during their whole IVF care, i.e., TLT or CI. Couples were followed up up to 2020, including all following frozen-embryo transfers and ICSI cycles (if any). Survival analysis was used to compare clinical outcome and time-related endpoints between both groups. Results: A total of 151 and 250 couples underwent their whole IVF care with the exclusive use of TLT and CI, respectively. Survival analysis showed that TCLBR after whole IVF care was significantly higher in TLT than in CI group (66.9 vs 56.4%, p=0.02, log-rank test). Median live birth time was significantly shorter in TLT than CI group (464 vs 596 days, p=0.01). Conclusions: We found that TCLBR and TTLB were significantly improved with TLT over CI in couples undergoing ICSI for male factor. This study fuels the debate on the clinical benefit of using TLT. The use of time-related endpoints adds important information for both patients and practitioners. [ABSTRACT FROM AUTHOR]

Background: Institutional delivery is an important indicator in monitoring the progress towards Sustainable Development Goal 3.1 to reduce the global maternal mortality ratio to less than 70 per 100,000 live births. Despite the international focus on reducing maternal mortality, progress has been low, particularly in Sub-Saharan Africa (SSA), with more than 295,000 mothers still dying during pregnancy and childbirth every year. Institutional delivery has been varied across and within the country. Therefore, this study aimed to investigate the individual and community level determinants, and spatial distribution of institutional delivery in Ethiopia. Methods: A secondary data analysis was done based on the 2016 Ethiopian Demographic and Health Survey (EDHS) data. A total weighted sample of 11,022 women was included in this study. For spatial analysis, ArcGIS version 10.6 statistical software was used to explore the spatial distribution of institutional delivery, and SaTScan version 9.6 software was used to identify significant hotspot areas of institutional delivery. For the determinants, a multilevel binary logistic regression analysis was fitted to take to account the hierarchical nature of EDHS data. The Intra-class Correlation Coefficient (ICC), Median Odds Ratio (MOR), Proportional Change in Variance (PCV), and deviance (-2LL) were used for model comparison and for checking model fitness. Variables with p-values<0.2 in the bi-variable analysis were fitted in the multivariable multilevel model. Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) were used to declare significant determinant of institutional delivery. Results: The spatial analysis showed that the spatial distribution of institutional delivery was significantly varied across the country [global Moran's I = 0.04 (p<0.05)]. The SaTScan analysis identified significant hotspot areas of poor institutional delivery in Harari, south Oromia and most parts of Somali regions. In the multivariable multilevel analysis; having 2–4 births (AOR = 0.48; 95% CI: 0.34–0.68) and >4 births (AOR = 0.48; 95% CI: 0.32–0.74), preceding birth interval ≥ 48 months (AOR = 1.51; 95% CI: 1.03–2.20), being poorer (AOR = 1.59; 95% CI: 1.10–2.30) and richest wealth status (AOR = 2.44; 95% CI: 1.54–3.87), having primary education (AOR = 1.47; 95% CI: 1.16–1.87), secondary and higher education (AOR = 3.44; 95% CI: 2.19–5.42), having 1–3 ANC visits (AOR = 3.88; 95% CI: 2.77–5.43) and >4 ANC visits (AOR = 6.53; 95% CI: 4.69–9.10) were significant individual-level determinants of institutional delivery while being living in Addis Ababa city (AOR = 3.13; 95% CI: 1.77–5.55), higher community media exposure (AOR = 2.01; 95% CI: 1.44–2.79) and being living in urban area (AOR = 4.70; 95% CI: 2.70–8.01) were significant community-level determinants of institutional delivery. Conclusions: Institutional delivery was low in Ethiopia. The spatial distribution of institutional delivery was significantly varied across the country. Residence, region, maternal education, wealth status, ANC visit, preceding birth interval, and community media exposure were found to be significant determinants of institutional delivery. Therefore, public health interventions should be designed in the hotspot areas where institutional delivery was low to reduce maternal and newborn mortality by enhancing maternal education, ANC visit, and community media exposure. [ABSTRACT FROM AUTHOR]

A subset of the bottlenose dolphin Tursiops truncatus gephyreus population in Laguna, southern Brazil, specialize in foraging cooperatively with fishermen. In this study, we describe reproductive parameters for these dolphins and investigate whether this specialized tactic generates reproductive advantages for females that frequently engage in this unusual behavior. We analyzed photo-identification data collected during 233 boat-based surveys during 2007–2009 and 2013–2017. From 27,808 high-quality photographs, we identified and tracked the fate of 24 reproductive females and 45 of their calves. Calving was found to be seasonal, with most births occurring in late spring/summer. The average crude birth rate was 0.09, and estimated fecundity was 0.17. The mean inter-birth interval was 2.09 (for all calves) or 2.43 years (for surviving calves only). Survival to 1 and 2 years estimated by the Kaplan–Meier method was 0.78 (95% CI 0.65–0.92) and 0.65 (95% CI 0.51–0.83), respectively—which represents a survival rate in the second year of 0.83. We investigated the potential influence of birth timing, resource availability, and maternal foraging tactic, home range size and frequency of interaction with fishermen on calf survival. Timing of birth was a significant predictor of calf survival. Giving birth close to the local mullet season would provide lactating females with increased seasonal prey resources, leading to increased calf survival. Due to our sample size (n = 9 cooperative and 15 non-cooperative females), we could not conclude whether or not the cooperative foraging tactic influences calf survival and female reproductive success. We emphasize the importance of long-term monitoring of populations to understand regional life history characteristics and provide accurate information for viability analyses. [ABSTRACT FROM AUTHOR]

Objectives: To understand how having or being denied an abortion affects the likelihood of trying to become pregnant, overall pregnancy rates, and the rate and timing of an intended pregnancy in the future.Study Design: The Turnaway Study is a prospective cohort study of women who received or were denied a wanted abortion. Women were recruited from one of 30 US abortion facilities. We examined subsequent intended pregnancy among those who presented just under the facility's gestational limit and received an abortion (Near-Limit Abortion Group, n=413) and those who presented for abortion just beyond the facility's gestational limit, were denied an abortion and went on to parent the child (Parenting Turnaways, n=146). First, we modeled the probability of trying to become pregnant using multivariable mixed-effects logistic regression. We then used Cox proportional-hazards models to compare overall pregnancy rates and intended pregnancy rates over 5 years.Results: Parenting Turnaways had lower predicted probabilities of reporting trying to become pregnant in the first 1.5 years after birth/abortion than the Near-Limit Abortion Group. They also had lower pregnancy rates overall [40.4 per 100 woman-years vs. 53.5 per 100 woman-years, adjusted hazards ratio (aHR)=0.69, 95% confidence interval (CI): 0.54-0.89]. The 5-year intended pregnancy rate was low among both groups, but compared to the Near-Limit Abortion Group, Parenting Turnaways had a lower intended pregnancy rate (2.2 per 100 woman-years vs. 7.5 per 100 woman-years, aHR=0.29, 95% CI: 0.10-0.85).Conclusion: Being able to obtain a wanted abortion may enable women to have an intended pregnancy later.Implications: Ensuring that women can obtain an abortion for an unwanted pregnancy may enable them to have a subsequent pregnancy when they are ready to have a baby. [ABSTRACT FROM AUTHOR]

Objectives To investigate the associations of interpregnancy interval (IPI) with miscarriage, stillbirth, preterm delivery and small for gestational age delivery. Methods The study population comprised all women who had a live birth and at least one subsequent pregnancy in Denmark during the period from 1994 to 2010 (N = 328,577). Linear regression was used to estimate risk differences for miscarriage, stillbirth, preterm delivery and small for gestational age delivery according to IPI. Results The results were heterogeneous: the risk of miscarriage increased monotonically with the length of the IPI. Compared to women with IPIs of 18-23 months, women with IPIs of 0-5 months experienced 18.7 (13.1-24.2) fewer miscarriages per 1000 pregnancies, while women with IPIs of ≥ 60 months experienced 28.7 (23.4-34.0) more miscarriages per 1000 pregnancies. We found that women with IPIs of ≥ 60 months had 1.7 (0.4-3.0) more stillbirths per 1000 births compared to women with IPIs of 18-23 months. U-shaped associations were seen for preterm delivery and small for gestational age delivery with women with IPIs of 18-23 months experiencing the lowest risks of these outcomes. Conclusions for Practice The heterogeneity in associations between IPI and adverse pregnancy outcomes suggests that different mechanisms of action may be at play at various times in the antepartum period. While the finding for miscarriage suggests that fecundity is an important determinant for IPI, the findings for preterm delivery and small for gestational age delivery suggest the coexistence of the maternal depletion syndrome mechanism and the physiological regression mechanism and the finding for stillbirth speaks against a strict maternal depletion syndrome explanation. [ABSTRACT FROM AUTHOR]

The article discusses the transition from high to low fertility in Sub-Saharan Africa. Particular focus is given to differences between reproductive patterns in African and non-African countries. According to the author, the pace of fertility decline in Africa is significantly slower than in Asia and Latin America at similar stages of demographic transition. Details on differences in birth intervals, ideal family size, and demand for contraception are also presented. It is suggested that family planning programs should be supported and promoted. Other topics include economic development and unintended pregnancies.

This article quantifies the contribution of pre-treatment dynamic selection to the relationship between fertility timing and postsecondary attainment, after controlling for a rich set of predetermined characteristics. Eventual mothers and nonmothers are matched using their predicted birth hazard rate, which shares the desirable properties of a propensity score but in a multivalued treatment setting. I find that eventual mothers and matched nonmothers enter college at the same rate, but their educational paths diverge well before the former become pregnant. This pre-pregnancy divergence creates substantial differences in ultimate educational attainment that cannot possibly be due to the childbirth itself. Controls for predetermined characteristics and fixed effects do not address this form of dynamic selection bias. A dynamic model of the simultaneous childbirth-education sequencing decision is necessary to address it. [ABSTRACT FROM AUTHOR]

This short paper offers an original look at the fertility transition in India through the lens of the period parity progression ratios (PPPRs). Taking advantage of nearly 300,000 birth history data collected in three nationally representative surveys (National Family Health Survey, NFHS) conducted in 1992-1993, 1998-1999 and 2005-2006, fertility changes by parity are described from 1977 to 2004. The data indicate that the decline of fertility in India over the last 25 years has been primarily caused by a reduction of third and higher-order births and that a two-child family model is therefore emerging in the country. To assess the parity-based analysis, lifetime average parities are computed and compared to independently derived total fertility estimates from the Sample Registration System (SRS). The results show that the use of the parity progression ratios in the analysis of Indian survey data yields fairly consistent fertility levels and trends in comparison with traditional total fertility estimates obtained from the SRS and that the PPPRs present thus an alternative tool to estimate the consistency and quality of total fertility estimates derived from other data sources. [ABSTRACT FROM AUTHOR]

This short paper offers an original look at the fertility transition in India through the lens of the period parity progression ratios (PPPRs). Taking advantage of nearly 300,000 birth history data collected in three nationally representative surveys (National Family Health Survey, NFHS) conducted in 1992-1993, 1998-1999 and 2005-2006, fertility changes by parity are described from 1977 to 2004. The data indicate that the decline of fertility in India over the last 25 years has been primarily caused by a reduction of third and higher-order births and that a two-child family model is therefore emerging in the country. To assess the parity-based analysis, lifetime average parities are computed and compared to independently derived total fertility estimates from the Sample Registration System (SRS). The results show that the use of the parity progression ratios in the analysis of Indian survey data yields fairly consistent fertility levels and trends in comparison with traditional total fertility estimates obtained from the SRS and that the PPPRs present thus an alternative tool to estimate the consistency and quality of total fertility estimates derived from other data sources. [ABSTRACT FROM AUTHOR]

This article explores socioeconomic differences in the effect of family allowances on fertility. Although several studies have examined the relationship between cash benefits and fertility, few studies have addressed the possible differential effects of cash benefits on families of different income or education levels. I reconstructed the birth histories of women in the past two Israeli censuses of 1983 and 1995 to study socioeconomic differences in the effect of family allowances up to the seventh parity. The results indicate that family allowances have a significant effect at every parity. Using female education as an indicator of socioeconomic status, I find that socioeconomic status is a significant modifier of the effect of family allowances. Family allowances seem to have a relatively large impact on more-educated women. [ABSTRACT FROM AUTHOR]

The possible negative consequences of current low fertility levels are causing increasing concern, particularly in countries where the total fertility rate is below 1.5. Social inertia and self-reinforcing processes may make it difficult to return to higher levels once fertility has been very low for some time, creating a possible “low-fertility trap.” Policies explicitly addressing the fertility-depressing effect of increases in the mean age at child-bearing (the tempo effect) may be a way to raise period fertility to somewhat higher levels and help escape the “low-fertility trap” before it closes. Reforms in the school system may affect the timing of childbearing by lowering the age at completion of education. A more efficient school system, which provides the same qualifications with a younger school-leaving age, is potentially capable of increasing period fertility and hence exerting a rejuvenating effect on the age composition, even if the levels of cohort fertility remain unchanged. Such policies may also have a positive effect on completed cohort fertility. [ABSTRACT FROM AUTHOR]

Censuses and surveys frequently collect information on period fertility through questions on the timing of last births. The standard approach to estimating fertility with open-interval data uses the proportion of women giving birth in the year before the interview. I propose a more efficient, maximum likelihood method for estimating fertility from open-interval data. I illustrate a mathematical derivation of the new method, perform sensitivity analyses, and conduct empirical tests with Brazilian census data. The new estimators have small biases and lower variance than standard estimators for open-interval data. Consequently, the new method is more likely to generate accurate results from small or moderately sized samples. [ABSTRACT FROM AUTHOR]

The monthly distribution of births for Hobart Town, Van Diemen's Land, during the period 1839-1859 is examined. Prior research on two rural registration districts in nineteenth-century Tasmania revealed patterns of birth seasonality. The pattern was responsive to both the distinctive seasonal rhythm of regional economic activities and the birth interval and differed from the pattern for all of Tasmania in the twentieth century. Here. I argue that the aggregate monthly pattern of births in a mid-nineteenth-century urban registration district was, by contrast, not seasonal. Some seasonality was found among farmers, seamen, and dealers in foodstuffs but not in other industry groups. Class differences were not apparent. The research establishes that the seasonal distribution of mid-nineteenth-century urban births corresponds neither to nineteenth-century rural patterns nor to the patterns evident in the twentieth century. [ABSTRACT FROM AUTHOR]

Indirect techniques are applied to estimate the current level of fertility and mortality among Kuwaiti nationals in Kuwait during 1980–85. The various methods discussed provide estimates in the vicinity of 45 per thousand for birth rate and 8 per thousand for death rate. While child spacing by birth order in Kuwait is about 2 years, the proportion of childlessness is very low (1%). As a consequence of lower mortality and stable high fertility, the Kuwaiti population remains young. [ABSTRACT FROM PUBLISHER]

The article discusses the birth rate, fertility and public health policy in the U.S. One research shows that there has been a decline in birth rates from 1970 to 1975 while fertility rate was found to be one-quarter flat in the intercensal decade between 1960 and 1970. Public health policy and programs are implemented to overcome some barriers. It has been indicated that the workplace served as an effective venue for family planning education and services mostly for women with lowered fertility demand.