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21 世纪印度近亲婚姻、妊娠结局与子女死亡率的关联

Linkages between consanguinity, pregnancy outcomes and offspring mortality in twenty-first century India.

机构信息

Narasinha Dutt College, Howrah, India.

University of Limerick, Limerick, Ireland.

出版信息

Sci Rep. 2024 Sep 28;14(1):22522. doi: 10.1038/s41598-024-69151-7.

Abstract

We hypothesized that consanguineous marriage will remain a risk factor for pregnancy outcome and offspring mortality, but the development in demographic, socioeconomic conditions and increased utilization of maternal and child health care services during postglobalization era would work as a buffer in the reduction of child mortality rates. Data fromNational Family Health Surveys 4(2015-2016) and 5(2019-2021) were pooled and used for the analysis. Binary logistic regression and Cox proportional hazard regression models were used to examine the effects of close (CC) and distant (DC) consanguinity on spontaneous abortion, stillbirth, neonatal mortality, post-neonatal, and child mortality respectively compared to non-consanguinity (NC). The final model showed that the risk of spontaneous abortion (both CC and DC, p < 0.001) and neonatal mortality (DC, p < 0.001) were significantly higher compared to NC. No significant association was found between consanguinity and child mortality. We conclude that the endogenous effect of consanguinity still pose a serious challenge to the survival of fetus and new born; but exogenous effect reduces the risk of child death. We propose to incorporate socially entrenched practice of consanguinity explicitly into Mosley and Chen's (1984) framework for the aid in understanding child survival in developing countries.

摘要

我们假设近亲结婚仍然是妊娠结局和子女死亡率的一个风险因素,但在后全球化时代,人口、社会经济状况的发展以及孕产妇和儿童保健服务利用率的提高,将起到缓冲作用,降低儿童死亡率。本研究对 2015-2016 年和 2019-2021 年的两轮国家家庭健康调查(NFHS)数据进行了汇总和分析。使用二元逻辑回归和 Cox 比例风险回归模型,分别比较了近亲(CC)和远亲(DC)结婚与非近亲(NC)结婚对自然流产、死产、新生儿死亡率、新生儿后和儿童死亡率的影响。最终模型显示,与 NC 相比,自然流产(CC 和 DC,p<0.001)和新生儿死亡率(DC,p<0.001)的风险明显更高。近亲结婚与儿童死亡率之间没有显著关联。我们的结论是,近亲结婚的内在效应仍然对胎儿和新生儿的生存构成严重挑战;但外在效应降低了儿童死亡的风险。我们建议将社会上根深蒂固的近亲结婚习俗明确纳入 Mosley 和 Chen(1984)的框架,以帮助理解发展中国家的儿童生存问题。

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