Most studies on the impact of birth intentions on children's well‐being do not separate risks of infant mortality associated with pregnancy intention status from the risks that are associated with sociodemographic characteristics. There is a lack of studies taking a multicountry comparative perspective. We analyzed 60 Demographic and Health Surveys in Asia, the Americas, and Africa to examine the association between birth intentions and infant mortality using sibling fixed‐effects linear probability models accounting for confounding due to time‐invariant maternal characteristics. Compared to wanted births, the probability of infant mortality was higher after an unwanted or mistimed birth, or both, in 41 countries. Particularly in West Africa, mostly mistimed pregnancies were associated with infant mortality, whereas in the Americas unwanted pregnancies mattered more. These differences could be partly due to contextual variation in the concept of birth intentions and in the importance of birth spacing and limiting. We show that the risk of infant mortality after an unwanted/mistimed pregnancy was higher in countries with low human development index and high overall infant mortality rate, highlighting the importance of taking context into account rather than pooling data. To the best of our knowledge, this is the first large‐scale, cross‐regional, and cross‐country comparative study to analyze the association between birth intentions and infant mortality using a fixed‐effects approach.

中文翻译：

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出生意愿状况和婴儿死亡率：60 个国家的固定效应分析


大多数关于出生意向对儿童福祉影响的研究并没有将与怀孕意向状态相关的婴儿死亡风险与与社会人口特征相关的风险分开。缺乏多国比较视角的研究。我们分析了亚洲、美洲和非洲的 60 项人口统计和健康调查，使用兄弟姐妹固定效应线性概率模型来研究出生意向和婴儿死亡率之间的关联，该模型考虑了由于时不变的母亲特征造成的混杂因素。与想要的分娩相比，在 41 个国家中，意外分娩或不合时宜的分娩或两者兼而有之的婴儿死亡概率更高。特别是在西非，大多数不合时宜的怀孕都与婴儿死亡率有关，而在美洲，意外怀孕的影响更大。这些差异可能部分归因于出生意图概念的背景差异以及生育间隔和限制的重要性。我们发现，在人类发展指数较低且婴儿总体死亡率较高的国家，意外/不合时宜的怀孕后婴儿死亡的风险较高，这凸显了考虑具体情况而不是汇总数据的重要性。据我们所知，这是第一项采用固定效应方法分析出生意愿与婴儿死亡率之间关系的大规模、跨地区、跨国比较研究。