孟加拉国童婚与母亲及其五岁以下子女营养状况的关联:一项具有全国代表性样本的横断面研究。

Association of child marriage and nutritional status of mothers and their under-five children in Bangladesh: a cross-sectional study with a nationally representative sample.

作者信息

Mim Shanta Akter, Al Mamun Abu Sayed Md, Sayem Md Abu, Wadood Md Abdul, Hossain Md Golam

机构信息

Health Research Group, Department of Statistics, University of Rajshahi, Rajshahi, 6205, Bangladesh.

出版信息

BMC Nutr. 2024 May 2;10(1):67. doi: 10.1186/s40795-024-00874-6.

Abstract

BACKGROUND

Child marriage remains an important problem around the world with young mothers and their under-five children often experiencing under-nutrition. The problem is rarely studied in the Bangladeshi population. This paper was designed to identify the association between child marriage and nutritional status of mothers and their under-five children in Bangladesh.

METHODS

Nationally representative secondary data was used for this study, data was extracted from the Bangladesh Demographic and Health Survey (BDHS) 2017-18. The sample consisted of 7235 mothers aged 18-49 years and their under-five children. The mothers were classified into two classes according to their age at first marriage: (i) child marriage (marriage at < 18 years) and (ii) not child marriage (marriage at ≥ 18 years). The nutritional status of mothers was measured by body mass index (BMI), and under-five children's nutritional status was measured by (i) height-for-age (z-score) (stunting), (ii) weight-for-age (z-score) (underweight), and (iii) weight-for-height (z-score) (wasting). The chi-square test and two-level logistic regression model were used for data analysis using SPSS software (IBM version 20).

RESULTS

The prevalence of child marriage among Bangladeshi women was 69.0%, with the mean and median of age at the first marriage being 16.57 ± 2.83 years and 16 years, respectively. Of the mothers, 15.2% suffered from chronic energy deficiency (underweight), and 72.8% were married at < 18 years. The prevalence of stunting, underweight, and wasting among under-five children in Bangladesh was 31.0%, 22.0%, and 8.5%, respectively. Compared to women married at the age of ≥ 18 years, there was a significantly higher likelihood of chronic energy deficiency among women who married at < 18 years [Adjusted OR = 1.27, CI: 1.05-1.82; p < 0.05]. Under-five children of mothers married before the age of 18 were more likely to have stunting [Adjusted OR = 1.201, CI: 1.11-1.72; p < 0.05], wasting [Adjusted OR = 1.519, CI: 1.15-2.00; p < 0.01], and underweight [Adjusted OR = 1.150, CI: 1.09-1.82; p < 0.05] compared to children of mothers who married at age ≥ 18.

CONCLUSION

The rate of child marriage among Bangladeshi women is high, and it is significantly associated with malnutrition among mothers and their under-five children. The Bangladesh government can use the findings of this study to prevent and reduce child marriage and malnutrition among mothers and their under-five children to achieve sustainable development goals by 2030.

摘要

背景

童婚在全球范围内仍是一个重要问题,年轻母亲及其五岁以下的孩子常常面临营养不良的状况。在孟加拉国人口中,这一问题鲜少被研究。本文旨在确定孟加拉国童婚与母亲及其五岁以下孩子营养状况之间的关联。

方法

本研究使用了具有全国代表性的二手数据,数据取自2017 - 2018年孟加拉国人口与健康调查(BDHS)。样本包括7235名年龄在18 - 49岁的母亲及其五岁以下的孩子。母亲们根据初婚年龄被分为两类:(i)童婚(初婚年龄<18岁)和(ii)非童婚(初婚年龄≥18岁)。母亲的营养状况通过体重指数(BMI)衡量,五岁以下孩子的营养状况通过以下指标衡量:(i)年龄别身高(z评分)(发育迟缓)、(ii)年龄别体重(z评分)(体重不足)和(iii)身高别体重(z评分)(消瘦)。使用卡方检验和二级逻辑回归模型,通过SPSS软件(IBM版本20)进行数据分析。

结果

孟加拉国女性中童婚的患病率为69.0%,初婚年龄的均值和中位数分别为16.57±2.83岁和16岁。在这些母亲中,15.2%患有慢性能量缺乏(体重不足),72.8%在18岁之前结婚。孟加拉国五岁以下儿童中发育迟缓、体重不足和消瘦的患病率分别为31.0%、22.0%和8.5%。与18岁及以上结婚的女性相比,18岁以下结婚的女性患慢性能量缺乏的可能性显著更高[调整后的比值比(OR)=1.27,置信区间(CI):1.05 - 1.82;p<0.05]。18岁前结婚的母亲所生的五岁以下儿童比18岁及以上结婚的母亲所生的儿童更易出现发育迟缓[调整后的OR = 1.201,CI:1.11 - 1.72;p<0.05]、消瘦[调整后的OR = 1.519,CI:1.15 - 2.00;p<0.01]和体重不足[调整后的OR = 1.150,CI:1.09 - 1.82;p<0.05]。

结论

孟加拉国女性童婚率很高,且与母亲及其五岁以下孩子的营养不良显著相关。孟加拉国政府可利用本研究结果预防和减少母亲及其五岁以下孩子的童婚和营养不良问题,以实现到2030年的可持续发展目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/43ca/11067235/e42a78c492f8/40795_2024_874_Fig1_HTML.jpg

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