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五岁以下儿童健康状况不佳的不良关联:以巴基斯坦为例的案例研究。

Undesired nexus poor health status of child under-five: A case study of Pakistan.

作者信息

Zainab Urva, Abbas Mohsin, Urooj Amena, Rabia Mahwish, Sun Huaping, Ahmed Shehzad Muhammad

机构信息

PIDE School of Economics, Pakistan Institute of Development Economics, Islamabad, Pakistan.

School of Economics and Management, University of Science and Technology Beijing, Beijing, China.

出版信息

PLoS One. 2025 May 30;20(5):e0323845. doi: 10.1371/journal.pone.0323845. eCollection 2025.

Abstract

Childhood morbidity and mortality are key indicators of human development, particularly reflecting poor health conditions in children. In Pakistan, child mortality remains a serious problem despite efforts to reduce it. One factor that may be associated with child mortality is an undesired pregnancy, whether unwanted (the parents did not want more children) or mistimed (the pregnancy occurred earlier than desired). Unwanted pregnancies and births are psychological factors that negatively impact children's nutritional health. The main objective of the study is to measure the impact of mothers' aspired status on child mortality and morbidity in Pakistan. We limited our analysis to children under 5 before the survey and used Pakistan demographic health survey conducted in 2017-2018, a national representative cross-sectional survey. We were able to predict the unwanted state (excess in boys, girls, both, and parity) by subtracting the ideal number of children from total live births. Morbidity (fever, diarrhea, cough, acute respiration infection, and Short rapid breathing), nutritional status, and mortality were also evaluated. We perform machine learning techniques such as random forest (RF) and neural network (NN) in the analysis of the data. The findings revealed that the overall percentage of the undesired child was 8%, 4%, 15%, and 27% for boys, girls, parity, and dual excess, respectively. Finally, we perform multivariate analysis following the principal component analysis (PCA) to study the relationship between variables. All the variables were associated with the unwanted child. Child morbidity, fever, and cough were higher among the undesired children. We found evidence that undesired children have acute respiration infection and that an unwanted child has a significant impact on childhood diseases. The ratio of child mortality was lower for boys but higher for girls.

摘要

儿童发病率和死亡率是人类发展的关键指标,尤其能反映儿童健康状况不佳。在巴基斯坦,尽管已努力降低儿童死亡率,但这仍是一个严重问题。可能与儿童死亡率相关的一个因素是意外怀孕,无论是不想要的(父母不想再要孩子)还是时机不当的(怀孕时间早于预期)。意外怀孕和生育是对儿童营养健康产生负面影响的心理因素。本研究的主要目的是衡量母亲期望状况对巴基斯坦儿童死亡率和发病率的影响。我们将分析限制在调查前5岁以下的儿童,并使用了2017 - 2018年进行的巴基斯坦人口健康调查,这是一项具有全国代表性的横断面调查。我们通过从总活产数中减去理想子女数来预测意外状况(男孩、女孩、两者及胎次的超额情况)。还评估了发病率(发烧、腹泻、咳嗽、急性呼吸道感染和呼吸急促)、营养状况和死亡率。我们在数据分析中运用了随机森林(RF)和神经网络(NN)等机器学习技术。研究结果显示,男孩、女孩、胎次和双重超额情况下意外儿童的总体比例分别为8%、4%、15%和27%。最后,我们在主成分分析(PCA)之后进行多变量分析,以研究变量之间的关系。所有变量都与意外儿童相关。意外儿童的发病率、发烧和咳嗽情况更高。我们发现有证据表明意外儿童患有急性呼吸道感染,且意外儿童对儿童疾病有重大影响。男孩的儿童死亡率较低,而女孩较高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c3e/12124503/0ab5ebc9f4c9/pone.0323845.g001.jpg

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