Ahinkorah Bright Opoku
School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Australia.
Arch Public Health. 2021 Aug 24;79(1):151. doi: 10.1186/s13690-021-00674-5.
The prevalence of childhood morbidity remains high in low-and middle-income countries, including sub-Saharan Africa (SSA). In this study, the association between maternal age at first childbirth and under-five morbidity in SSA was examined.
This was a cross-sectional study involving nationally-representative data from the most recent Demographic and Health Surveys conducted in 32 countries in SSA from 2010 to 2019. A sample size of 311,603 mothers of children under-five was considered. The outcome variable for this study was under-five morbidity. This variable was derived from the experience of fever, cough, and diarrhoea among children under-five. Both multilevel and binary logistic regression models were used to test the hypothesis that adolescent childbirth is associated with under-five morbidity. The results were presented as crude odds ratios (cORs) and adjusted odds ratios (aORs), with 95 % confidence intervals (CIs).
Children born to mothers whose first childbirth occurred at < 20 years were 16 % times more likely to suffer from under-five morbidity, compared to those whose mothers' first childbirth occurred at age ≥ 20 years [cOR = 1.16; CI = 1.13-1.19], and this persisted but with reduced odds after controlling for covariates [aOR = 1.10; CI = 1.07-1.12]. At the country level, children born to mothers whose first childbirth occurred at < 20 years were more likely to suffer from under-five morbidity, compared to those whose mothers' first childbirth occurred at age ≥ 20 years in Angola, Burundi, Congo DR, Guinea, Kenya, and Uganda.
In this study, an association between adolescent childbirth and morbidity in children under five in SSA has been established. The study concludes that under-five morbidity is higher among children born to mothers whose first childbirth occurred before 20 years compared to those whose mothers' first childbirth occurred at 20 years and above. The findings indicate that in order to reduce under-five morbidity, there is the need to deal with adolescent childbearing through cultural and social change, coupled with engagement of adolescents and stakeholders in adolescent sexual and reproductive health programmes.
在包括撒哈拉以南非洲（SSA）在内的低收入和中等收入国家，儿童发病率仍然很高。在本研究中，调查了撒哈拉以南非洲首次生育时的母亲年龄与五岁以下儿童发病率之间的关联。
这是一项横断面研究，涉及2010年至2019年在撒哈拉以南非洲32个国家进行的最新人口与健康调查中的全国代表性数据。考虑了311,603名五岁以下儿童的母亲作为样本量。本研究的结果变量是五岁以下儿童发病率。该变量源自五岁以下儿童发烧、咳嗽和腹泻的经历。使用多级和二元逻辑回归模型来检验青少年生育与五岁以下儿童发病率相关的假设。结果以粗比值比（cORs）和调整后的比值比（aORs）以及95%置信区间（CIs）呈现。
与母亲首次生育年龄≥20岁的儿童相比，首次生育年龄<20岁的母亲所生的儿童患五岁以下儿童疾病的可能性高16%[cOR = 1.16；CI = 1.13 - 1.19]，在控制协变量后这种情况仍然存在，但比值降低[aOR = 1.10；CI = 1.07 - 1.12]。在国家层面，在安哥拉、布隆迪、刚果民主共和国、几内亚、肯尼亚和乌干达，与母亲首次生育年龄≥20岁的儿童相比，首次生育年龄<20岁的母亲所生的儿童更易患五岁以下儿童疾病。
在本研究中，已确定撒哈拉以南非洲青少年生育与五岁以下儿童发病率之间存在关联。研究得出结论，与母亲首次生育年龄在20岁及以上的儿童相比，首次生育年龄在20岁之前的母亲所生的儿童五岁以下儿童发病率更高。研究结果表明，为了降低五岁以下儿童发病率，需要通过文化和社会变革来应对青少年生育问题，同时让青少年和利益相关者参与青少年性与生殖健康项目。
