影响一般人群中婴儿死亡率的因素：来自 2016 年埃塞俄比亚人口与健康调查（EDHS）的证据；多水平分析。
Factors affecting infant mortality in the general population: evidence from the 2016 Ethiopian demographic and health survey (EDHS); a multilevel analysis.
机构信息
Department of Epidemiology and Biostatistics, University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Gondar, Ethiopia.
Department of Human Nutrition, University of Gondar, College of Medicine and Health Sciences, Institute of Public Health, Gondar, Ethiopia.
出版信息
BMC Pregnancy Childbirth. 2020 May 15;20(1):299. doi: 10.1186/s12884-020-03002-x.
BACKGROUND
Infant mortality is one of the leading public health problems globally; the problem is even more staggering in low-income countries. In Ethiopia seven in ten child deaths occurred during infancy in 2016. Even though the problem is devastating, updated information about the major determinants of infant mortality which is done on a countrywide representative sample is lacking. Therefore, this study was aimed to identify factors affecting infant mortality among the general population of Ethiopia, 2016.
METHODS
A Community-based cross-sectional study was conducted in all regions of Ethiopia from January 18 to June 27, 2016. A total of 10,641 live births were included in the analysis. Data were analyzed and reported with both descriptive and analytic statistics. Bivariable and multivariable multilevel logistic regression models were fitted by accounting correlation of individuals within a cluster. Adjusted odds ratio (AOR) with 95% confidence interval was reported to show the strength of the association and its significance.
RESULTS
A total of 10,641 live-births from the Ethiopian demographic and health survey (EDHS) data were included in the analysis. Being male infant (AOR = 1.51; 1.25, 1.82), Multiple birth (AOR = 5.49; 95% CI, 3.88-7.78), Preterm (AOR = 8.47; 95% CI 5.71, 12.57), rural residents (AOR = 1.76; 95% CI; 1.16, 2.67), from Somali region (AOR = 2.07; 1.29, 3.33), Harari (AOR = 2.14; 1.22, 3.75) and Diredawa (AOR = 1.91; 1.04, 3.51) were found to be statistically significantly associated with infant mortality.
CONCLUSION
The study has assessed the determinants of infant mortality based on EDHS data. Sex of the child, multiple births, prematurity, and residence were notably associated with infant mortality. The risk of infant mortality has also shown differences across different regions. Since infant mortality is still major public health problem interventions shall be done giving more attention to infants who were delivered multiple and who are preterm.
背景
婴儿死亡率是全球主要的公共卫生问题之一；在低收入国家，这个问题更加严重。2016 年，埃塞俄比亚每 10 名儿童中有 7 人在婴儿期死亡。尽管这个问题具有破坏性，但缺乏关于全国代表性样本中婴儿死亡率主要决定因素的最新信息。因此，本研究旨在确定 2016 年埃塞俄比亚一般人群中影响婴儿死亡率的因素。
方法
2016 年 1 月 18 日至 6 月 27 日，在埃塞俄比亚所有地区进行了一项基于社区的横断面研究。共有 10641 例活产纳入分析。使用描述性和分析性统计数据对数据进行分析和报告。通过考虑个体在聚类中的相关性，拟合了单变量和多变量多层次逻辑回归模型。报告调整后的优势比（AOR）和 95%置信区间以显示关联的强度及其显著性。
结果
本研究共纳入了来自埃塞俄比亚人口与健康调查（EDHS）数据的 10641 例活产。男婴（AOR=1.51；1.25，1.82）、多胎（AOR=5.49；95%CI，3.88-7.78）、早产（AOR=8.47；95%CI，5.71，12.57）、农村居民（AOR=1.76；95%CI；1.16，2.67）、来自索马里地区（AOR=2.07；1.29，3.33）、哈拉里（AOR=2.14；1.22，3.75）和德雷达瓦（AOR=1.91；1.04，3.51）与婴儿死亡率呈统计学显著相关。
结论
本研究根据 EDHS 数据评估了婴儿死亡率的决定因素。儿童的性别、多胎、早产和居住地与婴儿死亡率显著相关。不同地区的婴儿死亡率也存在差异。由于婴儿死亡率仍然是一个主要的公共卫生问题，因此应采取干预措施，更加关注多胎分娩和早产的婴儿。
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