A new study led by researchers at East Tennessee State University’s College of Public Health has been published in Preventive Medicine Reports. The article, “Geospatial analysis of area-level social and behavioral factors associated with short interpregnancy intervals in North Carolina, U.S.” highlights how social, behavioral, and geographic factors influence short pregnancy intervals (sIPI) across North Carolina.
The research team included faculty members Qian Huang and Kate Beatty from ETSU’s Center for Applied Research and Evaluation (CARE) in Women’s Health, partners at the University of North Carolina at Charlotte and the WNC Health Network. The team conducted a geospatial analysis to explore where sIPI was most prevalent and what social and behavioral factors were associated with it.
Short interpregnancy intervals (sIPI), defined as conceiving a child within six months of a previous birth, are associated with adverse birth outcomes such as preterm delivery. The study found significant geographic clustering of sIPI in both western mountain and southern coastal counties of North Carolina. While no significant differences emerged between rural and urban areas, the researchers found strong associations between higher rates of sIPI and poverty, lack of vehicle access, and smoking during pregnancy. By contrast, counties with higher rates of breastfeeding initiation and educational attainment had lower rates of short pregnancy intervals.
"The study demonstrates that short interpregnancy intervals are shaped not only by individual decisions but also by broader social and structural determinants, including poverty, transportation barriers, and limited access to health services," said Dr. Qian Huang, lead author and research assistant professor in the college’s Department of Biostatistics and Epidemiology. "By mapping these patterns across North Carolina, the research identifies counties where targeted strategies, such as comprehensive school-based sexual health education, group prenatal care, and expanded access to family planning and obstetric services, could be most effective."
These findings provide evidence to guide communities and policymakers in developing interventions that promote healthier pregnancies and improve maternal and child health outcomes.