Mishra S K, Ram Bali, Singh Abhishek, Yadav Awdhesh
*L.B.S. College,Mughalsarai,Uttar Pradesh,India.
†Carleton University,Ottawa,Ontario,Canada.
J Biosoc Sci. 2018 Sep;50(5):604-625. doi: 10.1017/S0021932017000487. Epub 2017 Oct 2.
Using data from India's National Family Health Survey, 2005-06 (NFHS-3), this article examines the patterns of relationship between birth order and infant mortality. The analysis controls for a number of variables, including mother's characteristics such as age at the time of survey, current place of residence (urban/rural), years of schooling, religion, caste, and child's sex and birth weight. A modest J-shaped relationship between birth order of children and their risk of dying in the neonatal period is found, suggesting that although both first- and last-born children are at a significantly greater risk of dying compared with those in the middle, last-borns (i.e. fourth and higher order births) are at the worst risk. However, in the post-neonatal period first-borns are not as vulnerable, but the risk increases steadily with the addition of successive births and last-borns are at much greater risk, even worse than those in the neonatal period. Although the strength of relationship between birth order and mortality is attenuated after the potential confounders are taken into account, the relationship between the two variables remains curvilinear in the neonatal period and direct in the post-neonatal period. There are marked differences in these patterns by the child's sex. While female children are less prone to the risk of dying in the neonatal period in comparison with male children, the converse is true in the post-neonatal period. Female children not only run higher risks of dying in the post-neonatal period, but also become progressively more vulnerable with an increase in birth order.
本文利用印度2005 - 2006年全国家庭健康调查(NFHS - 3)的数据,研究出生顺序与婴儿死亡率之间的关系模式。分析控制了多个变量,包括母亲的特征,如调查时的年龄、当前居住地(城市/农村)、受教育年限、宗教、种姓,以及孩子的性别和出生体重。研究发现孩子的出生顺序与其新生儿期死亡风险之间呈适度的J形关系,这表明尽管头胎和末胎孩子与中间胎次的孩子相比死亡风险显著更高,但末胎(即第四胎及以上)的风险最高。然而,在新生儿后期,头胎孩子并非那么脆弱,但随着胎次的增加风险稳步上升,末胎孩子的风险更大,甚至比新生儿期更糟。尽管在考虑潜在混杂因素后出生顺序与死亡率之间的关系强度有所减弱,但这两个变量之间的关系在新生儿期仍呈曲线关系,在新生儿后期呈直接关系。这些模式在孩子性别方面存在显著差异。与男性孩子相比,女性孩子在新生儿期死亡风险较低,但在新生儿后期情况相反。女性孩子不仅在新生儿后期死亡风险更高,而且随着出生顺序的增加变得越来越脆弱。