了解印度产妇高风险生育行为与儿童营养水平之间的关联:来自 2015-2016 年国家家庭健康调查的证据。

Understanding the associations between maternal high-risk fertility behaviour and child nutrition levels in India: evidence from the National Family Health Survey 2015-2016.

机构信息

International Institute for Population Sciences (IIPS), Mumbai, India.

出版信息

Sci Rep. 2022 Oct 22;12(1):17742. doi: 10.1038/s41598-022-20058-1.

Abstract

Anthropometric markers are the most important aspect of a child's health assessment. Using large-scale nationally representative data from the National Family Health Survey (NFHS-4), 2015-2016, this study aimed to investigate the relationship between children born to women with high-risk fertility behaviours and children's health outcomes. The sample consisted of 2,55,726 children of currently married women aged 15-49 years in India. The key explanatory variable, high-risk fertility behaviour was defined by women's age at birth (below 18 or above 34 years), birth interval (less than 24 months), and higher birth orders (four and above). The key outcome variables for assessing child health outcomes were stunting, wasting, and underweight in children aged 0-59 months. We used descriptive statistics, Pearson's chi-square test and logistic regression models to analyse the objectives. Approximately 33% of children were born with any single high-risk condition in the last 5 years in India. The bivariate analysis showed that all three components of child health, stunting, wasting, and underweight, were higher among children born to women with high-risk fertility behaviour. The findings from the multivariable analysis suggest that children born with a high risk fertility behaviour were suffering from stunting (AOR = 1.30; 95% CI 1.27-1.33) and underweight (AOR = 1.23; 95% CI 1.20-1.27). In addition, children born to women of multiple high-risk categories had higher odds of stunting (AOR = 1.53; 95% CI 1.46-1.59) and underweight (AOR = 1.38; 95% CI 1.32-1.44) as compared to children born to women with no risk. Our findings highlight an urgent need for effective legislation to prevent child marriage that would be helpful in increasing the maternal age at birth. The government should also focus on the interventions in health education and improvement of reproductive healthcare to promote optimal birth spacing.

摘要

人体测量标志物是儿童健康评估的最重要方面。本研究使用来自 2015-2016 年全国家庭健康调查(NFHS-4)的大规模全国代表性数据,旨在调查具有高风险生育行为的妇女所生儿童与儿童健康结果之间的关系。样本包括印度目前已婚年龄在 15-49 岁的 255726 名妇女的 255726 名儿童。关键解释变量高风险生育行为由妇女的出生年龄(18 岁以下或 34 岁以上)、出生间隔(少于 24 个月)和较高的出生顺序(4 个及以上)定义。评估儿童健康结果的关键结果变量是 0-59 个月儿童的发育迟缓、消瘦和体重不足。我们使用描述性统计、皮尔逊卡方检验和逻辑回归模型来分析目标。在印度,大约 33%的儿童在过去 5 年内出生时存在任何单一的高风险状况。 双变量分析表明,所有三个儿童健康组成部分(发育迟缓、消瘦和体重不足)在具有高风险生育行为的妇女所生的儿童中都较高。多变量分析的结果表明,具有高风险生育行为的儿童患有发育迟缓(AOR=1.30;95%CI 1.27-1.33)和体重不足(AOR=1.23;95%CI 1.20-1.27)。此外,出生于多个高风险类别的妇女的儿童比出生于无风险妇女的儿童发育迟缓(AOR=1.53;95%CI 1.46-1.59)和体重不足(AOR=1.38;95%CI 1.32-1.44)的几率更高。我们的研究结果强调了迫切需要有效的立法来预防童婚,这将有助于提高产妇出生年龄。政府还应关注健康教育和生殖保健干预措施,以促进最佳生育间隔。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/14e5/9588050/ff859246a5d6/41598_2022_20058_Fig1_HTML.jpg

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