Mtongwa Ramadhani H, Festo Charles, Elisaria Ester
The Nelson Mandela Institution of Science and Technology in Collaboration with Ifakara Health Institute, P.O. Box 447, Arusha, Tanzania.
Department of Impact Evaluation, Health System and Policy Analysis, Ifakara Health Institute, Plot 463, Kiko Avenue Mikocheni, P.O. Box 78 373, Dar es Salaam, Tanzania.
BMC Nutr. 2021 Nov 4;7(1):64. doi: 10.1186/s40795-021-00468-6.
Tanzania is one of the Sub-Saharan African country with nearly 12 out of 60 million people being adolescent. The prevalence of child marriage is higher with one out of every three girls being married before reaching their 18th birthday, 5 % being married by the age of 15, and 31% by the age of 18 years. Literature shows early pregnancy is associated with Low Birth Weight (LBW) and stunting among children under 5 years. This paper explores variation and factors associated with low birth weight and stunting among children born by adolescent and non-adolescent mothers.
Data from 13,266 women with children under 5 years collected as part of the 2015/2016 TDHS was re-analyzed using STATA version 14 software while accounting for survey design. A total of 6385 women (of which 7.2% were adolescent) and 8852 women (of which 6.7% were adolescent) were involved in the analysis of child birth weight and stunting respectively. Descriptive statistics stratified by maternal age was conducted with LBW and stunting as outcome variables followed by logistic regressions models controlling for confounding variables.
The proportion of obese or overweight adolescent and non-adolescent mothers was 11.8 and 36.5% respectively. Antenatal care (ANC) attendance, areas of residence and social economic status were very similar in the two maternal age groups. Non- adolescent mothers had reduced odds of giving birth to LBW babies compared to adolescent mothers (Adjusted Odds Ratio (AOR) = 0.34; 95% CI: 0.22-0.50). Maternal undernutrition (AOR = 2.29; 95% CI: 1.43-3.67), being divorced, separated or widowed (AOR = 1.76; 95% CI: 1.24-2.50) and having at least four ANC visits (AOR = 0.64; 95% CI: 0.49-0.83) were significantly associated with reduced odds of having a LBW. Child stunting was not associated with maternal age. Maternal high socioeconomic status (AOR = 0.69; 95% CI: 0.57-0.84) and maternal obesity or overweight (AOR = 0.77; 95% CI: 0.64-0.92) were negatively associated with stunting. Child birth weight, sex, and age were significantly associated with stunting.
Maternal age was a predictor of LBW but not stunting. ANC attendance and not living with a spouse increase the risk of LBW babies. Stunting was associated with low maternal body mass index (BMI), low socioeconomic status, child birth weight, gender, and age. A multi-sectoral approach is needed to address child nutrition problems with teenagers 'specific intervention that offer emotional support, and health education during pregnancies for improving immediate and later life child birth outcomes.
坦桑尼亚是撒哈拉以南非洲国家之一，6000万人口中近12%为青少年。童婚率较高，每三名女孩中就有一人在18岁之前结婚，5%在15岁结婚，31%在18岁结婚。文献表明，早孕与5岁以下儿童的低出生体重（LBW）和发育迟缓有关。本文探讨青少年母亲和非青少年母亲所生孩子低出生体重和发育迟缓的差异及相关因素。
作为2015/2016年坦桑尼亚人口与健康调查的一部分，收集了13266名有5岁以下儿童的妇女的数据，使用STATA 14软件重新分析，同时考虑调查设计。分别有6385名妇女（其中7.2%为青少年）和8852名妇女（其中6.7%为青少年）参与了儿童出生体重和发育迟缓的分析。以LBW和发育迟缓作为结果变量，按母亲年龄进行描述性统计，随后进行控制混杂变量的逻辑回归模型分析。
肥胖或超重的青少年母亲和非青少年母亲的比例分别为11.8%和36.5%。两个母亲年龄组的产前护理（ANC）就诊率、居住地区和社会经济地位非常相似。与青少年母亲相比，非青少年母亲生出低出生体重婴儿的几率降低（调整后的优势比（AOR）=0.34；95%置信区间：0.22 - 0.50）。母亲营养不良（AOR = 2.29；95%置信区间：1.43 - 3.67）、离婚、分居或丧偶（AOR = 1.76；95%置信区间：1.24 - 2.50）以及至少进行四次ANC就诊（AOR = 0.64；95%置信区间：0.49 - 0.83）与生出低出生体重婴儿的几率降低显著相关。儿童发育迟缓与母亲年龄无关。母亲高社会经济地位（AOR = 0.69；95%置信区间：0.57 - 0.84）和母亲肥胖或超重（AOR = 0.77；95%置信区间：0.64 - 0.92）与发育迟缓呈负相关。儿童出生体重、性别和年龄与发育迟缓显著相关。
母亲年龄是低出生体重的一个预测因素，但不是发育迟缓的预测因素。ANC就诊率和与配偶不住在一起会增加生出低出生体重婴儿的风险。发育迟缓与母亲低体重指数（BMI）、低社会经济地位、儿童出生体重、性别和年龄有关。需要采取多部门方法来解决儿童营养问题，针对青少年进行特定干预，在孕期提供情感支持和健康教育，以改善近期和后期的儿童出生结局。
