Department of Environmental Health, Harvard University, Boston, MA, USA.
Department of Statistics, Miami University, 334B Upham Hall, Oxford, OH, 45056, USA.
BMC Public Health. 2024 May 2;24(1):1213. doi: 10.1186/s12889-024-18486-x.
Risk factors of infant mortality in Africa and south Asian countries have been broadly discussed. However, infant morbidity is largely underestimated. We analyzed the data from a randomized vaccine trial in Bangladesh to identify and assess the effect of risk factors on infant morbidity.
Pregnant women were randomly assigned to receive either inactivated influenza vaccine or pneumococcal polysaccharide vaccine and the infants were randomly assigned to receive 7-valent pneumococcal conjugate vaccine or Hib conjugate vaccine at week 6, 10 and 14. The data were collected from August 2004 through December 2005. Each pair of infant and mother were followed for 24 weeks after birth with weekly visits. Generalized estimating equations (GEE) for repeated measurements and Poisson regression models were used to identify the risk factors and evaluate their effect on the longitudinal incidence and total number of episodes of respiratory illness with fever (RIF), diarrhea disease, ear problem and pneumonia.
A total of 340 pregnant women were randomized with mean age of 25 years. The baseline mother and infant characteristics were similar between two treatment groups. Exclusive breastfeeding and higher paternal education level were common factors associated with lower infant morbidity of RIF (adjusted OR = 0.40 and 0.94 with p < 0.01 and p = 0.02, respectively), diarrhea disease (adjusted OR = 0.39 and 0.95 with p < 0.01 and p = 0.04, respectively), and ear problem (adjusted OR = 0.20 and 0.76 with p < 0.01 and p < 0.01, respectively). Maternal influenza vaccine significantly reduced the incidence of RIF (adjusted OR = 0.54; p < 0.01) but not diarrhea disease or ear problem (p > 0.05). Female infants had lower incidence of diarrhea disease (adjusted OR = 0.67; p = 0.01) and ear problem (adjusted OR = 0.12; p = 0.01).
Maternal influenza vaccination, exclusive breastfeeding, female children, and higher paternal education level significantly reduced the infant morbidity within the 24 weeks after birth in Bangladesh.
非洲和南亚国家婴儿死亡率的风险因素已得到广泛讨论。然而，婴儿发病率在很大程度上被低估了。我们分析了在孟加拉国进行的一项随机疫苗试验的数据，以确定并评估风险因素对婴儿发病率的影响。
孕妇被随机分配接受灭活流感疫苗或肺炎球菌多糖疫苗，婴儿在 6、10 和 14 周时随机分配接受 7 价肺炎球菌结合疫苗或 Hib 结合疫苗。数据收集于 2004 年 8 月至 2005 年 12 月。每对母婴在出生后 24 周内每周进行一次随访。使用广义估计方程（GEE）进行重复测量和泊松回归模型来确定风险因素，并评估其对发热性呼吸道疾病（RIF）、腹泻病、耳部问题和肺炎的纵向发病率和总发作次数的影响。
共有 340 名孕妇被随机分组，平均年龄为 25 岁。两组治疗的孕妇和婴儿的基线特征相似。纯母乳喂养和父亲较高的教育水平是与 RIF（调整后的 OR=0.40 和 0.94，p<0.01 和 p=0.02）、腹泻病（调整后的 OR=0.39 和 0.95，p<0.01 和 p=0.04）和耳部问题（调整后的 OR=0.20 和 0.76，p<0.01 和 p<0.01）的婴儿发病率较低相关的常见因素。母亲接种流感疫苗可显著降低 RIF 的发生率（调整后的 OR=0.54；p<0.01），但不会降低腹泻病或耳部问题的发生率（p>0.05）。女婴腹泻病（调整后的 OR=0.67；p=0.01）和耳部问题（调整后的 OR=0.12；p=0.01）的发生率较低。
在孟加拉国，母亲接种流感疫苗、纯母乳喂养、女孩和父亲较高的教育水平可显著降低婴儿出生后 24 周内的发病率。
