Research Scholar, International Institute for Population Sciences, Mumbai, Maharashtra.
Omega (Westport). 2024 Mar;88(4):1606-1627. doi: 10.1177/00302228211066695. Epub 2021 Dec 28.
Despite knowledge of neonatal and postneonatal mortality determinants in Bangladesh, some families continue to lose a larger share of children, a phenomenon known as early-life mortality clustering. This study uses the random intercept Weibull survival regression model to explore the correlation of mortality risk among siblings at the family (or, mother) and community levels. Utilizing the Bangladesh Demographic and Health Survey 2017-2018, we found evidence of death scarring, where children whose previous sibling was not alive at the time of conception had significantly higher odds of neonatal mortality. Moreover, the neonatal (and postneonatal) mortality hazard was highest for children with a birth interval of fewer than 19 months, corresponding to the preceding sibling. The intraclass correlation coefficient's statistically significant values show that neonatal and postneonatal mortality risk is correlated among children of the same family and community. The findings suggest focusing on high-risk families and communities to reduce the mortality level effectively.
尽管孟加拉国有关于新生儿和围生期后死亡率决定因素的知识，但一些家庭的孩子仍然持续大量死亡，这种现象被称为早逝聚集。本研究利用随机截距 Weibull 生存回归模型，探讨了家庭（或母亲）和社区层面上兄弟姐妹之间死亡率风险的相关性。利用 2017-2018 年孟加拉国人口与健康调查的数据，我们发现了死亡痕迹的证据，即在受孕时前一个兄弟姐妹已经去世的儿童，其新生儿死亡率的可能性显著更高。此外，出生间隔少于 19 个月的儿童（新生儿和围生期后）的死亡率危险最高，这与前一个兄弟姐妹相对应。内部类别相关系数的统计显著值表明，同一家庭和社区的儿童的新生儿和围生期后死亡率风险存在相关性。研究结果表明，需要关注高风险家庭和社区，以有效降低死亡率水平。
