Date of Award

January 2023

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)



First Advisor

Saad B. Omer


Although seasonal patterns in the distribution of live births have been well described across distinct populations for centuries, little is known about determinants of birth seasonality, particularly among low- and middle-income countries. Knowledge of determinants of birth seasonality may assist in the timely implementation and distribution of maternal and child health resources that may morbidity and mortality. In this study we examined for maternal and household sociodemographic determinants of birth seasonality in a sample of 3,260,238 live births across 49 nations that are included in the United States Agency for International Development Demographic and Health Survey Program. Our findings demonstrate that birth seasonality is independently associated with maternal and household sociodemographic characteristics including maternal age at birth, maternal body mass index, maternal education, and household wealth. Additionally, we demonstrate that temperature at time of conception is an independent predictor of birth seasonality. We also document trends in the directionality and magnitude of independent predictors of birth seasonality between the Northern and Southern Hemispheres as well as across maternal religious affiliations. The knowledge of seasonal trends in births along with its sociodemographic predictors offers meaningful insights that can be directed towards public health resources that have the potential to improve maternal and child health outcomes and more targeted public health campaigns in low- and middle-income countries.


This is an Open Access Thesis.

Open Access

This Article is Open Access