Determinants of Postpartum Amenorrhea in Rural Manipur: Socio-Demographic and Nutritional Factors

Abstract

Postpartum amenorrhea (PPA) is a key factor influencing the spacing of births. This study investigates the determinants affecting the duration of PPA among women in rural Manipur. A cross-sectional, community-based survey was carried out involving 979 ever-married women with at least one live birth, across four valley districts. Using cluster sampling, data collection occurred from July 2019 to February 2020. Survival analysis was applied to assess censored data. The median duration of PPA was determined to be 6 months. The analysis revealed a significant positive correlation between PPA duration and the length of breastfeeding (P<0.01). Additionally, infant mortality, particularly the death of a previous child during infancy, significantly impacted PPA duration. Socio-economic variables, including family income and religious affiliation (specifically Islam), also influenced the duration of amenorrhea. In summary, this study identified several critical factors affecting PPA duration, including infant mortality, breastfeeding practices, socio-economic status, and religious affiliation. These findings highlight the complex interplay between biological, socio-economic, and cultural factors in determining postpartum amenorrhea.