Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
BMC Pregnancy Childbirth. 2021 May 1;21(1):345. doi: 10.1186/s12884-021-03792-8.
Globally, infant mortality has declined considerably but has remained unacceptably high in sub-Saharan Africa, especially Nigeria where infant mortality rate is 67/1000 live births. To facilitate infant mortality reduction in Nigeria, an understanding of the synergistic effect of bio-demographic characteristics of mothers known as High Risk Birth Behaviours (HrBBs) is important. We therefore investigated the influence of HrBBs on infant survival in Nigeria.
This cross-sectional study design utilized data from the 2018 round of Nigerian Demographic Health Survey. The study participants were a representative sample of women of reproductive age (n = 21,350) who had given birth within the 5 years preceding the survey. HrBBs was measured through integration of information on maternal age at child's birth, parity, and preceding birth interval with respect to the most recent child. The HrBBs was categorized as none, single and multiple. Data were analysed using descriptive statistics, Log-rank test and Cox proportional hazard model (α =0.05).
The mean age of the women was 29.7 ± 7.2 and 4.1% had experienced infant death. Infant mortality was highest among women with multiple HrBBs (5.1%). Being a male, having small size at birth, failure to receive tetanus injection, non-use of contraceptives and living in the core-north (North West and North East) predisposed children to higher risk of dying before 12 months of age. The hazard ratio of infant mortality was significantly higher among infants of mothers in multiple HrBBs category (aHR = 1.66; CI: 1.33-2.06) compared to their counterparts with no HrBBs.
Multiple HrBBs increase the chances of dying among infants in Nigeria. Screening women for HrBBs for special health attention during pregnancy, birth and postnatal period will alleviate infant death in Nigeria.
全球范围内，婴儿死亡率已大幅下降，但在撒哈拉以南非洲地区仍居高不下，尤其是尼日利亚，其婴儿死亡率为每千例活产 67 例。为促进尼日利亚婴儿死亡率降低，了解被称为高风险生育行为（HrBBs）的母亲生物人口特征的协同效应非常重要。因此，我们调查了 HrBBs 对尼日利亚婴儿生存的影响。
本横断面研究设计利用了 2018 年尼日利亚人口健康调查的一轮数据。研究参与者是年龄在生育期（n=21350）的具有代表性的样本，她们在调查前的 5 年内分娩过。HrBBs 通过整合母亲生育时的年龄、胎次和最近一次生育的出生间隔信息来衡量。HrBBs 分为无、单和多。使用描述性统计、Log-rank 检验和 Cox 比例风险模型（α=0.05）进行数据分析。
女性的平均年龄为 29.7±7.2 岁，有 4.1%的婴儿死亡。在具有多种 HrBBs 的女性中，婴儿死亡率最高（5.1%）。男孩、出生体重小、未接种破伤风疫苗、未使用避孕药具以及居住在核心北部（西北和东北）会增加儿童在 12 个月前死亡的风险。与没有 HrBBs 的母亲相比，处于多 HrBBs 类别的母亲的婴儿死亡风险比（aHR=1.66；CI：1.33-2.06）显著更高。
多种 HrBBs 增加了尼日利亚婴儿死亡的几率。在怀孕期间、分娩期间和产后对女性进行 HrBBs 筛查，为其提供特殊的健康关注，将减轻尼日利亚婴儿死亡的现象。
