Olukade Tawa O, Uthman Olalekan A
Department of Pediatrics, Hamad Medical Corporation, Doha 3050, Qatar.
Warwick-Centre for Global Health (WCGH), Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK.
Children (Basel). 2022 Aug 20;9(8):1260. doi: 10.3390/children9081260.
Sub-Saharan African (SSA) newborns are ten times more likely to die in the first month than a neonate born in a high-income country. The objective of this study was to examine the relationship between educational attainment and neonatal mortality (NM) among women with cesarean section (CS) deliveries in SSA countries.
Using data from recent demographic and health surveys from 33 countries in SSA, we applied propensity score matching to estimate the effect of education attainment on post-CS neonatal mortality using a propensity-matched cohort where being educated was defined as completing at least primary school education Results: The number of reported CS births ranged from 186 in Niger to 1695 in Kenya. The odds of neonatal mortality between uneducated and educated women ranged from as low as 2.31 in Senegal to 35.5 in Zimbabwe, with a pooled overall risk for NM from all of the countries of OR 2.54 (95% CI: 1.72-3.74) and aOR 1.7 (95% CI: 1.12-2.57). From the 17,220 respondents, we successfully matched 11,162 educated respondents with 2146 uneducated respondents. Uneducated women had a 6% risk compared to a 2.9% risk among educated women for neonatal mortality, with an overall risk of 3.4%; babies from uneducated women were twice as likely to die compared to babies from educated women, RR 2.1 (95% CI, 1.69-2.52).
Neonates from uneducated women were twice as likely to die following CS delivery than neonates from educated women. This evidence suggests that a means of achieving Sustainable Development Goal target 3.2 to lower newborn and child mortality is ensuring that everyone has access to high-quality care with efforts made at ensuring education for all and improving socio-economic conditions.
撒哈拉以南非洲（SSA）地区的新生儿在出生后第一个月死亡的可能性是高收入国家新生儿的十倍。本研究的目的是探讨SSA国家剖宫产（CS）分娩妇女的教育程度与新生儿死亡率（NM）之间的关系。
利用SSA 33个国家近期人口与健康调查的数据，我们应用倾向得分匹配法，通过一个倾向匹配队列来估计教育程度对剖宫产术后新生儿死亡率的影响，其中受过教育被定义为至少完成小学教育。结果：报告的剖宫产出生人数从尼日尔的186例到肯尼亚的1695例不等。未受过教育和受过教育的妇女之间新生儿死亡的几率从塞内加尔的低至2.31到津巴布韦的35.5不等，所有国家新生儿死亡的综合总体风险为OR 2.54（95%CI：1.72 - 3.74），调整后OR为1.7（95%CI：1.12 - 2.57）。在17220名受访者中，我们成功地将11162名受过教育的受访者与2146名未受过教育的受访者进行了匹配。未受过教育的妇女新生儿死亡风险为6%，而受过教育的妇女为2.9%，总体风险为3.4%；未受过教育妇女所生婴儿死亡的可能性是受过教育妇女所生婴儿的两倍，RR为2.1（95%CI，1.69 - 2.52）。
未受过教育的妇女所生新生儿在剖宫产分娩后死亡的可能性是受过教育的妇女所生新生儿的两倍。这一证据表明，实现可持续发展目标3.2以降低新生儿和儿童死亡率的一种方法是确保每个人都能获得高质量的护理，同时努力确保全民教育并改善社会经济状况。
