Abstract #301260

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JSM 2003 Abstract #301260
Activity Number: 133
Type: Contributed
Date/Time: Monday, August 4, 2003 : 12:00 PM to 1:50 PM
Sponsor: Biometrics Section
Abstract - #301260
Title: Study of Contraceptive Effect of Breast Feeding
Author(s): Ashwini K. Mathur*+ and B. P. Madhura+ and H. Vaman
Companies: GlaxoSmithKline and GlaxoSmithKline and Bangalore University
Address: N2, 9th Floor, 'The Estate', Bangalore, Karnataka, , 560042, India India Liaison Office, N2, 9th Floor, 'The Estate', Bangalore, , 560042, India
Keywords: postpartum amenorrhoea ; Markov process ; semi-Markov process ; hierarchical modeling ; sojourn times
Abstract:

Along with many benefits of breast feeding (BF), its effect on extending the duration of postpartum amenorrhoea (DPA) is also well documented. Reports on effect of total duration of BF on DPA exist, but study of influence of levels and durationss of BF, that is, Complete BF (CBF), Partial BF (PBF), or a combination (CBF+PBF) is more appropriate when considering real life situations. In this paper an effort has been made to measure the influence of duration and level of BF using three statistical models, namely, (1) Markov model; (2) semi-Markov model, and (3) hierarchical model. Results based on these models and limitations of each model will be highlighted. For example, the Markov model is modeled as a finite homogeneous and absorbing Markov process. Durations of BF at different levels is not used explicitly in this model. Since DPA is expected to increase with duration of BF, assumption of a common (exponential in our case) distribution is invalid. A semi-Markov model was thus developed. Another shortcoming of both models is that they do not address the effects of various covariates on DPA. The hierarchical model was developed to study covariates age, parity, and education.

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