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低、中收入国家中,生育间隔过短对儿童死亡率的负面影响:系统评价和荟萃分析。

Negative effects of short birth interval on child mortality in low- and middle-income countries: A systematic review and meta-analysis.

机构信息

Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh.

Department of Population Science and Human Resource Development, University of Rajshahi, Bangladesh.

出版信息

J Glob Health. 2022 Sep 3;12:04070. doi: 10.7189/jogh.12.04070.

DOI:10.7189/jogh.12.04070
PMID:36057919
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9441110/
Abstract

METHODS

Eight databases, PubMed, CINAHL, Web of Science, Embase, PsycINFO, Cochrane Library, Popline, and Maternity and Infant Care, were searched, covering the period of January 2000 to January 2022. Studies that had examined the association between SBI and any form of child mortality were included. The findings of the included studies were summarized through fixed-effects or random-effects meta-analysis and the model was selected based on the heterogeneity index.

RESULTS

A total of 51 studies were included. Of them, 19 were conducted in Ethiopia, 10 in Nigeria and 7 in Bangladesh. Significant higher likelihoods of stillbirth (odds ratio (OR) = 2.11; 95% confidence interval (CI) = 1.32-3.38), early neonatal mortality (OR = 1.58; 95% CI = 1.04-2.41), perinatal mortality (OR = 1.71; 95% CI = 1.32-2.21), neonatal mortality (OR = 1.85; 95% CI = 1.68-2.04), post-neonatal mortality (OR = 3.01; 95% CI = 1.43-6.33), infant mortality (OR = 1.92; 95% CI = 1.77-2.07), child mortality (OR = 1.67; 95% CI = 1.27-2.19) and under-five mortality (OR = 1.95; 95% CI = 1.56-2.44) were found among babies born in short birth intervals than those who born in normal intervals.

CONCLUSIONS

SBI significantly increases the risk of child mortality in LMICs. Programmes to reduce pregnancies in short intervals need to be expanded and strengthened. Reproductive health interventions aimed at reducing child mortality should include proper counselling on family planning, distribution of appropriate contraceptives and increased awareness of the adverse effects of SBI on maternal and child health.

摘要

方法

检索了 2000 年 1 月至 2022 年 1 月期间的 8 个数据库,包括 PubMed、CINAHL、Web of Science、Embase、PsycINFO、Cochrane 图书馆、Popline 和母婴保健。纳入了研究 SBI 与任何形式的儿童死亡之间关联的研究。通过固定效应或随机效应荟萃分析总结纳入研究的结果,并根据异质性指数选择模型。

结果

共纳入 51 项研究。其中,19 项在埃塞俄比亚进行,10 项在尼日利亚进行,7 项在孟加拉国进行。死产的可能性显著增加(比值比(OR)=2.11;95%置信区间(CI)=1.32-3.38),早期新生儿死亡(OR=1.58;95%CI=1.04-2.41),围产期死亡(OR=1.71;95%CI=1.32-2.21),新生儿死亡(OR=1.85;95%CI=1.68-2.04),新生儿后死亡(OR=3.01;95%CI=1.43-6.33),婴儿死亡(OR=1.92;95%CI=1.77-2.07),儿童死亡(OR=1.67;95%CI=1.27-2.19)和五岁以下儿童死亡(OR=1.95;95%CI=1.56-2.44)在短生育间隔出生的婴儿中比在正常间隔出生的婴儿中更高。

结论

SBI 显著增加了 LMIC 中儿童死亡的风险。需要扩大和加强减少短生育间隔怀孕的计划。旨在降低儿童死亡率的生殖健康干预措施应包括适当的计划生育咨询、发放适当的避孕药具以及提高对 SBI 对母婴健康不良影响的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fc2/9441110/5124d0a0e919/jogh-12-04070-F1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fc2/9441110/5124d0a0e919/jogh-12-04070-F1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fc2/9441110/5124d0a0e919/jogh-12-04070-F1.jpg

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