Fertility behavior and reproductive outcomes among young Guatemalan adults.

Fertility rates have declined in many developing countries and this has implications for health and development of subsequent generations. Guatemala has the highest fertility rates in Central America. Reproductive histories were obtained by interview in 2002-04, in a cohort of 779 women and 647 men who had participated as young children in a nutrition supplementation trial in Guatemala conducted between 1969 and 1977. Most women (77%) and men (79%) are currently married. Among the 700 women and 524 men reporting at least one birth, mean age at first birth was 20.7 +/- 3.8 years and 23.1 +/- 3.9 years respectively. Knowledge (> 80%) and use (approximately 70%) of modern contraceptive methods is fairly high; knowledge increases with parental socioeconomic status (SES) as measured in 1975. Younger respondents have experienced fewer pregnancies and live births compared with older respondents; age-specific fertility rates between 20 and 24 years were 294, 249, 236, and 261 births per 1,000 women, respectively, for women born from 1962-65, 1966-69, 1969-73, and 1974-77. Women in the top tertile of parental SES have had significantly fewer pregnancies (3.3) compared with those in the middle (3.7) and lower (3.8) tertiles. Migrants to Guatemala City reported greater knowledge of contraceptive methods, fewer pregnancies and living children, higher age at first birth, and more pregnancy and newborn complications as compared with cohort members who remained in the original villages (p < .05 for each comparison). Fertility rates, especially between 20 and 24 years, have declined over time. Differences in reproductive behaviors by parental SES and current residence suggest the role of social transitions in determining family formation in Guatemala.