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孟加拉国低出生体重发生率及其相关决定因素的社会经济不平等。

Socioeconomic inequality in the prevalence of low birth weight and its associated determinants in Bangladesh.

机构信息

Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh.

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

出版信息

PLoS One. 2022 Oct 27;17(10):e0276718. doi: 10.1371/journal.pone.0276718. eCollection 2022.

Abstract

BACKGROUND AND OBJECTIVE

Low birth weight (LBW) is a major risk factor of child mortality and morbidity during infancy (0-3 years) and early childhood (3-8 years) in low and lower-middle-income countries, including Bangladesh. LBW is a vital public health concern in Bangladesh. The objective of the research was to investigate the socioeconomic inequality in the prevalence of LBW among singleton births and identify the significantly associated determinants of singleton LBW in Bangladesh.

MATERIALS AND METHODS

The data utilized in this research was derived from the latest nationally representative Bangladesh Demographic and Health Survey, 2017-18, and included a total of 2327 respondents. The concentration index (C-index) and concentration curve were used to investigate the socioeconomic inequality in LBW among the singleton newborn babies. Additionally, an adjusted binary logistic regression model was utilized for calculating adjusted odds ratio and p-value (<0.05) to identify the significant determinants of LBW.

RESULTS

The overall prevalence of LBW among singleton births in Bangladesh was 14.27%. We observed that LBW rates were inequitably distributed across the socioeconomic groups (C-index: -0.096, 95% confidence interval: [-0.175, -0.016], P = 0.029), with a higher concentration of LBW infants among mothers living in the lowest wealth quintile (poorest). Regression analysis revealed that maternal age, region, maternal education level, wealth index, height, age at 1st birth, and the child's aliveness (alive or died) at the time of the survey were significantly associated determinants of LBW in Bangladesh.

CONCLUSION

In this study, socioeconomic disparity in the prevalence of singleton LBW was evident in Bangladesh. Incidence of LBW might be reduced by improving the socioeconomic status of poor families, paying special attention to mothers who have no education and live in low-income households in the eastern divisions (e.g., Sylhet, Chittagong). Governments, agencies, and non-governmental organizations should address the multifaceted issues and implement preventive programs and policies in Bangladesh to reduce LBW.

摘要

背景和目的

低出生体重(LBW)是包括孟加拉国在内的低收入和中低收入国家婴儿期(0-3 岁)和幼儿期(3-8 岁)儿童死亡和发病的主要危险因素。LBW 是孟加拉国一个重要的公共卫生关注点。本研究的目的是调查孟加拉国单胎出生 LBW 的社会经济不平等现象,并确定与单胎 LBW 显著相关的决定因素。

材料和方法

本研究使用的是来自 2017-18 年最新的全国代表性孟加拉国人口与健康调查的数据,共包括 2327 名受访者。集中指数(C 指数)和集中曲线用于调查孟加拉国单胎新生儿 LBW 的社会经济不平等情况。此外,还使用调整后的二元逻辑回归模型计算调整后的比值比和 p 值(<0.05),以确定 LBW 的显著决定因素。

结果

孟加拉国单胎出生的 LBW 总患病率为 14.27%。我们发现,LBW 率在社会经济群体中分布不均(C 指数:-0.096,95%置信区间:[-0.175,-0.016],P=0.029),生活在最低财富五分位数(最贫困)的母亲所生的 LBW 婴儿比例较高。回归分析表明,母亲年龄、地区、母亲教育程度、财富指数、身高、初产年龄以及调查时儿童的存活状况(存活或死亡)是孟加拉国 LBW 的显著决定因素。

结论

本研究表明,孟加拉国单胎 LBW 的患病率存在社会经济差异。通过改善贫困家庭的社会经济地位,特别关注没有受过教育且生活在东部地区(如锡尔赫特、吉大港)低收入家庭的母亲,可以降低 LBW 的发生率。政府、机构和非政府组织应解决多方面的问题,并在孟加拉国实施预防计划和政策,以降低 LBW 发生率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1af0/9612499/e45a155aae4f/pone.0276718.g001.jpg

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