Institute For Global Health, University College London, London, UK.
Perinatal Care Project, Diabetic Association of Bangladesh, Dhaka, Bangladesh.
J Epidemiol Community Health. 2018 Oct;72(10):888-895. doi: 10.1136/jech-2017-210134. Epub 2018 Jun 15.
Women's groups interventions in Bangladesh reduced neonatal deaths by 38% and improved hygienic delivery, newborn care practices and breast feeding. We explore the longer-term impact of exposure to women's groups during pregnancy on child growth at 2-4 years.
We performed a cross-sectional survey of child anthropometric measures (analysed as z-scores) among children born to women who had participated in the women's groups interventions while pregnant, compared with an age-matched and sex-matched sample of children born to control mothers. Results were stratified by maternal body mass index (BMI) and adjusted for possible confounding effects of maternal education, household asset ownership and, in a separate model, mother-child height difference, a proxy for improved survival of small babies in intervention groups.
Data were obtained from 2587 mother-child pairs (91% response). After adjustment for asset ownership, maternal education and potential survival effects, children whose mothers were exposed to the women's group intervention had higher head (0.16 (0.04 to 0.28)), mid-upper arm (0.11 (0.04 to 0.19)), abdominal (0.13 (0.00 to 0.26)) and chest (0.18 (0.08 to 0.29)) circumferences than their control counterparts. No significant differences in subcutaneous fat (subscapular and triceps skinfold thickness) were observed. When stratified by maternal BMI, intervention children had higher weight, BMI and circumferences, and these effects decreased with increasing maternal BMI category.
Women's groups appear to have had a lasting, positive impact on child anthropometric outcomes, with most significant results clustering in children of underweight mothers. Observed differences are likely to be of public health significance in terms of the nutritional and metabolic development of children.
孟加拉国的妇女组织干预措施将新生儿死亡率降低了 38%，并改善了卫生分娩、新生儿护理实践和母乳喂养。我们探讨了怀孕期间接触妇女组织对 2-4 岁儿童生长的长期影响。
我们对出生于参与妇女组织干预的孕妇的儿童的儿童人体测量指标（分析为 z 分数）进行了横断面调查，与年龄和性别匹配的出生于对照组母亲的儿童样本进行了比较。结果按母体 BMI 分层，并调整了母体教育、家庭资产所有权以及在单独模型中，母亲-儿童身高差异（干预组中较小婴儿存活改善的替代指标）等可能的混杂效应。
从 2587 对母婴对中获得了数据（91%的响应率）。在调整了资产所有权、母亲教育和潜在生存效应后，母亲接触妇女组织干预的儿童的头围（0.16（0.04 至 0.28））、上臂中部（0.11（0.04 至 0.19））、腹部（0.13（0.00 至 0.26））和胸围（0.18（0.08 至 0.29））比对照组的儿童更大。未观察到皮下脂肪（肩胛下和肱三头肌皮褶厚度）的显著差异。按母体 BMI 分层时，干预组儿童的体重、BMI 和围度更高，这些影响随着母体 BMI 类别增加而降低。
妇女组织似乎对儿童人体测量结果产生了持久的积极影响，最显著的结果主要集中在体重不足的母亲的儿童中。观察到的差异在儿童的营养和代谢发育方面可能具有公共卫生意义。
