London School of Hygiene and Tropical Medicine, London, UK.
Lancet. 2010 Jun 5;375(9730):2024-31. doi: 10.1016/S0140-6736(10)60704-0.
The effect of a parent's death on the survival of the children has been assessed in only a few studies. We therefore investigated the effect of the death of the mother or father on the survival of the child up to age 10 years in rural Bangladesh.
We used data from population surveillance during 1982-2005 in Matlab, Bangladesh. We used Kaplan-Meier and Poisson regression analyses to compute the cumulative probabilities of survival and rates of age-specific death up to age 10 years, according to the survival status of the mother or father during that period.
There were 144 861 livebirths, and 14 868 children died by 10 years of age. The cumulative probability of survival to age 10 years was 24% in children whose mothers died (n=1385) before their tenth birthday, compared with 89% in those whose mothers remained alive (n=143 473). The greatest effect was noted in children aged 2-5 months whose mothers had died (rate ratio 25.05, 95% CI 18.57-33.81). The effect of the father's death (n=2691) on cumulative probability of survival of the child up to 10 years of age was negligible. Age-specific death rates did not differ in children whose fathers died compared with children whose fathers were alive.
The devastating effects of the mother's death on the survival of the child were most probably due to the abrupt cessation of breastfeeding, but the persistence of the effects up to 10 years of age suggest that the absence of maternal care might be a crucial factor.
US Agency for International Development, UK Department for International Development, Research Program Consortium, and National Institutes of Health Fogarty International Center.
仅有少数研究评估了父母一方去世对子女存活的影响。因此，我们在孟加拉国的 Matlab 地区开展了一项研究，旨在调查母亲或父亲去世对儿童存活至 10 岁的影响。
我们使用了 1982-2005 年期间人群监测的数据。我们采用 Kaplan-Meier 和 Poisson 回归分析，根据该时期内母亲或父亲的存活状态，计算存活至 10 岁的累积生存率和各年龄段死亡率。
共有 144861 例活产儿，其中 14868 例儿童在 10 岁前死亡。10 岁前母亲去世（n=1385）的儿童存活至 10 岁的累积概率为 24%，而母亲存活的儿童（n=143473）则为 89%。在 2-5 月龄的儿童中，母亲去世的影响最大（死亡比 25.05，95%CI 18.57-33.81）。父亲去世（n=2691）对儿童存活至 10 岁的累积概率的影响可忽略不计。与父亲在世的儿童相比，父亲去世的儿童各年龄段的死亡率没有差异。
母亲去世对儿童存活的毁灭性影响可能主要是由于母乳喂养的突然中断，但影响持续至 10 岁表明，母亲的缺失可能是一个关键因素。
美国国际开发署、英国国际发展部、研究计划联盟和美国国立卫生研究院 Fogarty 国际中心。
