title: The role of delayed childbearing in the prevention of obstetric fistulas.
abstract: OBJECTIVE
  To examine the role of delayed childbearing in the prevention of obstetric fistulas (OFs).
  
  
  METHODS
  Data on 4798 deliveries in Niger (1995-1998), 3552 in Nigeria (1996-1999), and 6789 in Tanzania (1991-1996) were analyzed with logistic regression models.
  
  
  RESULTS
  Young maternal age and primiparous status were identified as correlates of prolonged/obstructed labor. The annual incidence of OFs in Nigeria was found to be 2.11 per 1000 births, with 9817 cases developing each year, 28% in women and girls younger than 20 years. The predicted proportion of women experiencing prolonged/obstructed labor would be reduced by 11.2% in Niger, 11.4% in Nigeria, and 13.1% in Tanzania if the risks associated with young maternal age at first delivery and primiparity were eliminated.
  
  
  CONCLUSIONS
  Community programs to educate young, newly married women about delaying childbearing until they reach physical maturity should be implemented in countries with a high incidence of OFs.
authors.affiliation: Population, Family and Reproductive Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA. atsui@jhsph.edu
authors.forename: A O
authors.initials: AO
authors.lastname: Tsui
authors.forename: A A
authors.initials: AA
authors.lastname: Creanga
authors.forename: S
authors.initials: S
authors.lastname: Ahmed
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006266:Health Education; D006801:Humans; D008423:Maternal Age; D009548:Niger; D009549:Nigeria; D007744:Obstetric Labor Complications / Q000517:prevention & control*; D011247:Pregnancy; D012044:Regression Analysis; D012923:Social Class; D013636:Tanzania; D013997:Time Factors; D014624:Vaginal Fistula / Q000517:prevention & control*