The relationship between reduced child spacing and depression in mothers: A cross-sectional study in Karachi, Pakistan
- 1Medical College, The Aga Khan University, Karachi, Pakistan
- 2Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
Abstract
Short inter-birth intervals may increase maternal psychological stress and have been hypothesized to contribute to depressive symptoms. We assessed the association between recent birth spacing and depression in mothers in Karachi, Pakistan. We conducted a cross-sectional, interviewer-administered survey of mothers recruited via convenience sampling from public parks and shopping malls in Karachi. Eligible participants were mothers with ≥2 children who had delivered within the past five years; women who were currently pregnant or <2 months postpartum were excluded. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9); the primary outcome was PHQ-9 ≥ 10. Birth spacing was calculated as the interval between the two most recent live births and categorized as <24 months, 24–32 months, and ≥33 months (reference). We used logistic regression to estimate crude and adjusted odds ratios (aOR), adjusting for maternal age, education (formal vs none), number of children (2 vs ≥ 3), and household income (<50,000 vs ≥ 50,000 PKR). Of 202 completed questionnaires, 15 were excluded due to missing key exposure data, leaving 187 mothers for analysis; adjusted models included 181 participants. Overall, 37/187 (19.8%) screened positive for probable depression (PHQ-9 ≥ 10). Compared with spacing ≥33 months, the adjusted odds of PHQ-9 ≥ 10 were aOR 2.39, 95% CI 0.84–6.75 for spacing 24–32 months, and aOR 2.17, 95% CI 0.79–5.96 for <24 months. No formal education was associated with higher odds of PHQ-9 ≥ 10 (aOR 4.62, 95% CI 1.50–14.20). In this sample of mothers in Karachi, shorter birth spacing was not significantly associated with higher odds of probable depression. Larger, probability-based studies are needed to clarify the relationship between birth spacing and depression.
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BibTeX
@article{kazmi2026relationship,
title = {{The relationship between reduced child spacing and depression in mothers: A cross-sectional study in Karachi, Pakistan}},
author = {Syed Abbas Moazzam Kazmi and Muhammad Mushahid Hussain Rizvi and Sameen Nasir and Shahnoor Ahmed and Hawra Hussain and Haleema Sadia and Ayesha Siddiq and Aleena Asif and Maham Jaskani and Zulfiqar Jogezai and Noor us Sabahat and Abdul Basit Afzal and Asaad Ahmed Nafees},
journal = {PLOS Global Public Health},
year = {2026},
month = sep,
doi = {10.1371/journal.pgph.0007190},
url = {https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007190},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The relationship between reduced child spacing and depression in mothers: A cross-sectional study in Karachi, Pakistan
AU - Syed Abbas Moazzam Kazmi
AU - Muhammad Mushahid Hussain Rizvi
AU - Sameen Nasir
AU - Shahnoor Ahmed
AU - Hawra Hussain
AU - Haleema Sadia
AU - Ayesha Siddiq
AU - Aleena Asif
AU - Maham Jaskani
AU - Zulfiqar Jogezai
AU - Noor us Sabahat
AU - Abdul Basit Afzal
AU - Asaad Ahmed Nafees
PY - 2026
DA - 2026/09/10
JO - PLOS Global Public Health
DO - 10.1371/journal.pgph.0007190
UR - https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0007190
AB - Short inter-birth intervals may increase maternal psychological stress and have been hypothesized to contribute to depressive symptoms. We assessed the association between recent birth spacing and depression in mothers in Karachi, Pakistan. We conducted a cross-sectional, interviewer-administered survey of mothers recruited via convenience sampling from public parks and shopping malls in Karachi. Eligible participants were mothers with ≥2 children who had delivered within the past five years; women who were currently pregnant or <2 months postpartum were excluded. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9); the primary outcome was PHQ-9 ≥ 10. Birth spacing was calculated as the interval between the two most recent live births and categorized as <24 months, 24–32 months, and ≥33 months (reference). We used logistic regression to estimate crude and adjusted odds ratios (aOR), adjusting for maternal age, education (formal vs none), number of children (2 vs ≥ 3), and household income (<50,000 vs ≥ 50,000 PKR). Of 202 completed questionnaires, 15 were excluded due to missing key exposure data, leaving 187 mothers for analysis; adjusted models included 181 participants. Overall, 37/187 (19.8%) screened positive for probable depression (PHQ-9 ≥ 10). Compared with spacing ≥33 months, the adjusted odds of PHQ-9 ≥ 10 were aOR 2.39, 95% CI 0.84–6.75 for spacing 24–32 months, and aOR 2.17, 95% CI 0.79–5.96 for <24 months. No formal education was associated with higher odds of PHQ-9 ≥ 10 (aOR 4.62, 95% CI 1.50–14.20). In this sample of mothers in Karachi, shorter birth spacing was not significantly associated with higher odds of probable depression. Larger, probability-based studies are needed to clarify the relationship between birth spacing and depression.
SN - 2767-3375
ER -