Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
PLoS One. 2022 Jun 9;17(6):e0269279. doi: 10.1371/journal.pone.0269279. eCollection 2022.
Over the past three decades, undernutrition has become a major cause of morbidity and mortality among children under five years globally. Low birth weight has been identified as a risk factor for child morbidity and mortality, especially among children under five years in sub-Saharan Africa. There is, however, a paucity of empirical literature establishing the association between low birth weight and undernutrition in sub-Saharan Africa. We examined the association between birth weight and nutritional status of children under five in sub-Saharan Africa.
Our analyses were performed on a weighted sample of 110,497 children under five years from 32 countries in sub-Saharan Africa. Data were obtained from the Demographic and Health Surveys conducted from 2010 to 2019. We reported the prevalence of low birth weight and nutritional status (stunting, wasting, and underweight) for all the 32 countries using percentages. We used multilevel binary logistic regression to examine the association between birth weight and nutritional status (stunting, wasting, and underweight) of the children, controlling for covariates. The results of the regression analyses were presented using adjusted odds ratios (aOR) with 95% confidence intervals. Statistical significance was set at p<0.05.
The prevalence of low birth weight was 5.4%, with the highest (13.1%) and lowest (0.9%) reportedin South Africa and Chad, respectively. The pooled prevalence of wasting, underweight, and stunting were 8.1%, 17.0%, and 31.3%, respectively. Niger had the highest prevalence of wasting (21.5%) and underweight (37.1%), whereas Burundi had the highest prevalence of stunting (51.7%). We found that children with low birth weight were more likely to be stunted [aOR = 1.68, 95% CI = 1.58-1.78], underweight [aOR = 1.82, 95% CI = 1.70-1.94], and wasted [aOR = 1.35, 95% CI = 1.20-1.38] after controlling for covariates.
Our study has demonstrated that low birth weight is a key determinant of undernutrition among children under five in sub-Saharan Africa. Policymakers need to give special attention to improving the nutritional status of children under-five years in sub-Saharan Africa by implementing measures aimed at enhancing the weight of children. To accelerate progress towards the achievement of the Sustainable Development Goal 3.2 target of ending preventable deaths of newborns and under-five by 2030, it is imperative for countries in sub-Saharan Africa to intensify interventions aimed at improving maternal and child nutrition. Specific nutrition interventions such as dietary modification counselling should prioritized.
在过去的三十年中，营养不良已成为全球五岁以下儿童发病和死亡的主要原因。低出生体重已被确定为儿童发病和死亡的风险因素，尤其是在撒哈拉以南非洲五岁以下儿童中。然而，关于低出生体重与撒哈拉以南非洲儿童营养不良之间关联的实证文献很少。我们研究了低出生体重与撒哈拉以南非洲五岁以下儿童营养状况之间的关系。
我们对来自撒哈拉以南非洲 32 个国家的 110497 名五岁以下儿童的加权样本进行了分析。数据来自 2010 年至 2019 年进行的人口与健康调查。我们使用百分比报告了所有 32 个国家的低出生体重和营养状况（发育迟缓、消瘦和体重不足）的流行情况。我们使用多水平二项逻辑回归来检查出生体重与儿童营养状况（发育迟缓、消瘦和体重不足）之间的关联，同时控制了协变量。回归分析的结果以调整后的优势比（aOR）和 95%置信区间表示。统计学意义设定为 p<0.05。
低出生体重的流行率为 5.4%，其中南非和乍得的报告率最高（分别为 13.1%和 0.9%）。消瘦、体重不足和发育迟缓的总流行率分别为 8.1%、17.0%和 31.3%。尼日尔的消瘦（21.5%）和体重不足（37.1%）的流行率最高，而布隆迪的发育迟缓（51.7%）的流行率最高。我们发现，低出生体重的儿童更有可能发育迟缓（aOR=1.68，95%CI=1.58-1.78）、体重不足（aOR=1.82，95%CI=1.70-1.94）和消瘦（aOR=1.35，95%CI=1.20-1.38），这是在控制了协变量之后。
我们的研究表明，低出生体重是撒哈拉以南非洲五岁以下儿童营养不良的一个关键决定因素。决策者需要特别关注改善撒哈拉以南非洲五岁以下儿童的营养状况，实施旨在提高儿童体重的措施。为了加速实现到 2030 年消除可避免的新生儿和五岁以下儿童死亡的可持续发展目标 3.2 目标，撒哈拉以南非洲各国必须加强旨在改善母婴营养的干预措施。应优先考虑具体的营养干预措施，如饮食改变咨询。
