Alam N, van Ginneken J K
Health and Demographic Surveillance Programme, International Centre for Diarrhoeal Disease Research, Bangladesh.
Paediatr Perinat Epidemiol. 1999 Jan;13(1):78-88. doi: 10.1046/j.1365-3016.1999.00160.x.
It is recognized that one infant death in a family indicates an increased risk of death of a subsequent sibling. This study examines which cause of death of a sibling is related to the mortality of the younger sibling and when. Longitudinal vital events data from the maternal and child health and family planning (MCH-FP) project and the comparison areas in Matlab, Bangladesh, were used. Primary causes of 868 neonatal deaths and 624 post-neonatal deaths resulting from 18,865 singleton live births in 1989-92 and those (967 as neonates and 708 as post-neonates) of their immediate elder siblings were categorised into infectious and non-infectious diseases. Multinomial logistic regression was used to estimate the risk of younger siblings dying in each age period from infectious and non-infectious diseases given the age and cause of deaths of older siblings and controlling for other biosocial correlates of infant mortality. A neonatal death of non-infectious causes in a family was twice as likely to be followed by another one occurring at the same age from similar causes compared with a surviving infant followed by a neonatal death from non-infectious causes. The MCH-FP project, though successful in reducing the risk of neonatal and post-neonatal mortality from infectious diseases, did not reduce the risk of dying from non-infectious diseases.
人们认识到，家庭中出现一例婴儿死亡表明随后出生的兄弟姐妹死亡风险增加。本研究探讨了兄弟姐妹的何种死因与年幼兄弟姐妹的死亡率相关，以及在何时相关。研究使用了来自孟加拉国马特莱的妇幼保健和计划生育（MCH-FP）项目及对照地区的纵向生命事件数据。对1989 - 1992年18865例单胎活产导致的868例新生儿死亡和624例新生儿期后死亡及其年长同胞（分别为967例新生儿和708例新生儿期后儿童）的主要死因进行了分类，分为感染性疾病和非感染性疾病。在考虑年长同胞的年龄和死因并控制婴儿死亡率的其他生物社会相关因素的情况下，使用多项逻辑回归来估计年幼兄弟姐妹在每个年龄段因感染性和非感染性疾病死亡的风险。与存活婴儿随后出现非感染性原因的新生儿死亡相比，家庭中因非感染性原因导致的新生儿死亡之后，同一年龄出现类似原因的另一例新生儿死亡的可能性是其两倍。妇幼保健和计划生育项目虽然成功降低了新生儿和新生儿期后感染性疾病的死亡风险，但并未降低非感染性疾病的死亡风险。
