Maternal age and risk of early neonatal mortality: a national cohort study

Kim, Yoo-Na; Choi, Dong-Woo; Kim, Dong Seop; Park, Sohee; Kwon, Ja Young

doi:10.1038/s41598-021-80968-4

Cited by 35 publications

(26 citation statements)

References 35 publications

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“…Specifically, it was found that birth weight less than 2.5kg and above 4.5kg elevates the risk of underage five mortality. These findings are consistent with previous studies, [49,50].…”

Section: Discussionsupporting

confidence: 94%

Under Age Five Children Survival Times in Nigeria: A Bayesian Spatial Modelling Approach

Egbon

Bogoni

Babalola³

et al. 2021

Preprint

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Background: Nigeria is among the top five countries in the world with the highest under-five mortality rates. In addition to the general leading causes of under-five mortality, studies have shown that disparities in sociocultural values and practices across ethnic groups in Nigeria influence child survival, thus there is a need for scientific validation. Methods: The approach commonly adopted in multilevel modeling of the under-five mortality rate in Nigeria is to consider child death status as a binary outcome variable. In this manner, information about the time localization of mortality risk is lost in the process. This study quantified the impact of socioeconomic and demographic factors, proximate and biological determinants, and environmental factors on the risk of under-five mortality in Nigeria using a Bayesian hierarchical hazard model with time to death outcomes. The Exponential, Gamma, Log-normal, Weibull, and Cox hazard models in a mixed effect framework with spatial components were considered, and the best model was selected for inference. In addition, the Kaplan Meier survival curve, Nelson Aalen hazard curve, and components survival probabilities were estimated. Results: Findings show that gender, maternal education, household wealth status, source of water and toilet facility, residence, mass media, frequency of antenatal and postnatal visits, marital status, place of delivery, multiple births, who decide healthcare use, use of bednet are significant risk factors of child mortality in Nigeria. The mortality risk is high among the maternal age group below 24 and above 44years, and birth weight below 2.5Kg and above 4.5Kg. The under-five mortality risk is severe in Kebbi, Kaduna, Jigawa, Adamawa, Gombe, Kanu, Kogi, Nasarawa, Plateau, Sokoto states in Nigeria. Conclusions: This study accentuates the need for special attention for the first two months after childbirth as it is the age group with the highest expected mortality. A practicable way to minimize death in the early life of children is to improve maternal health care service, promote maternal education, encourage delivery in healthcare facilities, positive parental attitude to support multiple births, poverty alleviation programs for the less privileged, and a prioritized intervention to Northern Nigeria.

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“…Specifically, it was found that birth weight less than 2.5kg and above 4.5kg elevates the risk of underage five mortality. These findings are consistent with previous studies, [49,50].…”

Section: Discussionsupporting

confidence: 94%

Under Age Five Children Survival Times in Nigeria: A Bayesian Spatial Modelling Approach

Egbon

Bogoni

Babalola³

et al. 2021

Preprint

View full text Add to dashboard Cite

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“…0 times, 1–4 times, 5–7 times, 8 times or more). Maternal age at birth was classified in three categories (< 18, 18–34, 35 years or older) because both young and old maternal age are associated with higher risk of neonatal mortality 24 . Similarly, birth interval was classified in three categories (< 18, 18–59, 60 months and more) because long inter-pregnancy intervals (possibly longer than 5 years) and short intervals are independently associated with adverse pregnancy outcomes 25 .…”

Section: Methodsmentioning

confidence: 99%

Association of maternal history of neonatal death with subsequent neonatal death across 56 low- and middle-income countries

Kapoor

Kim

et al. 2021

Sci Rep

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Early identification of high-risk pregnancies can reduce global neonatal mortality rate. Using the most recent Demographic and Health Surveys from 56 low- and middle-income countries, we examined the proportion of mothers with history of neonatal deaths. Logistic regression models were used to assess the association between maternal history of neonatal death and subsequent neonatal mortality. The adjusted models controlled for socioeconomic, child, and pregnancy-related factors. Country-specific analyses were performed to assess heterogeneity in this association across countries. Among the 437,049 live births included in the study, 6910 resulted in neonatal deaths. In general, 22.4% (1549) occurred to mothers with previous history of neonatal death; at the country-level, this proportion ranged from 1.2% (95% confidence interval [CI] 0.0, 2.6) in Dominican Republic to 38.1% (95% CI 26.0, 50.1) in Niger. Maternal history of neonatal death was significantly associated with subsequent neonatal death in both the pooled and the subgroup analyses. In the fully adjusted model, history of neonatal death was associated with 2.1 (95% CI 1.9, 2.4) times higher odds of subsequent neonatal mortality in the pooled analysis. We observed large variation in the associations across countries ranging from fully adjusted odds ratio (FAOR) of 0.4 (95% CI 0.0, 4.0) in Dominican Republic to 16.1 (95% CI 3.6, 42.0) in South Africa. Our study suggests that maternal history of neonatal death could be an effective early identifier of high-risk pregnancies in resource-poor countries. However, country-specific contexts must be considered in national policy discussions.

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“…Globally, several studies have found that children born to mothers whose first childbirth occurred during adolescence are more likely to die before age 5 compared with those born to mothers whose first childbirth occurred in adulthood 26–29. In SSA, there are studies that have shown that adolescent pregnancy and childbirth do not only have short-term and medium-term negative effects on the adolescent girl but established long-term effects as well 30 31.…”

Section: Introductionmentioning

confidence: 99%

“…25 Globally, several studies have found that children born to mothers whose first childbirth occurred during adolescence are more likely to die before age 5 compared with those born to mothers whose first childbirth occurred in adulthood. [26][27][28][29] In SSA, there are studies that have shown that adolescent pregnancy and childbirth do not only have short-term and medium-term negative effects on the adolescent girl but established long-term effects as well. 30 31 These studies explained that most adolescents in SSA who have experienced adolescent pregnancy or childbirth are likely to be socioeconomically disadvantaged even after several years due to school drop-outs, unemployment, and abandonment by parents.…”

mentioning

confidence: 99%

Under-5 mortality in sub-Saharan Africa: is maternal age at first childbirth below 20 years a risk factor?

Ahinkorah

2021

BMJ Open

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ObjectivesThis study aimed at examining the association between young maternal age at first childbirth and under-5 mortality in sub-Saharan Africa (SSA).Design and settingThis cross-sectional study pooled nationally-representative data from the most recent Demographic and Health Surveys conducted in 30 countries in SSA from 2010 to 2019.Participants116 379 mothers of children under 5.ResultsThe prevalence of adolescent childbirth and death in children under 5 in SSA were 57.36% (95% CI 53.73% to 60.99%) and 4.10% (95% CI 3.65% to 4.54%), respectively. Children born to mothers whose first childbirth occurred at <20 years were 11% more likely to die before the age of 5 compared with those whose mothers’ first childbirth occurred at age ≥20 years (adjusted odds ratio (aOR) 1.11; 95% CI 1.05 to 1.18). In terms of the covariates, the likelihood of under-5 mortality was higher among children born to single (aOR 1.54; 95% CI 1.41 to 1.67) and cohabiting mothers (aOR 1.10; 95% CI 1.01 to 1.21) compared with married mothers. Children born to mothers who were obese were more likely to die before the age of 5 compared with those born to mothers with normal body weight (aOR 1.17; 95% CI 1.09 to 1.26). The odds of under-5 mortality were higher among children whose weight at birth was <2500 g compared with those whose weight was ≥2500 g at birth (aOR 1.83; 95% CI 1.64 to 2.03).ConclusionsThe findings call for the need to enhance policies aimed at reducing under-5 mortality in SSA by reducing adolescent pregnancy and childbirth through family planning, comprehensive sexuality education, and the elimination of child marriage. Again, Since under-5 mortality among adolescent mothers is linked with their poor socio-economic status, there is the need for government and non-governmental organisations in SSA to introduce poverty alleviation programmes and improve access to both formal and informal education as a way of enhancing the socioeconomic status of adolescent mothers. Public health education, through continuous advocacy programmes should be done to encourage adolescent mothers to access antenatal care and health facility deliveries as a way of enhancing the survival status of their children. These interventions should be implemented, taking into consideration other characteristics of mothers such marital status and BMI and child’s characteristics such as child’s weight, which were found to be associated with high under-5 mortality.

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Maternal age and risk of early neonatal mortality: a national cohort study

Cited by 35 publications

References 35 publications

Under Age Five Children Survival Times in Nigeria: A Bayesian Spatial Modelling Approach

Under Age Five Children Survival Times in Nigeria: A Bayesian Spatial Modelling Approach

Association of maternal history of neonatal death with subsequent neonatal death across 56 low- and middle-income countries

Under-5 mortality in sub-Saharan Africa: is maternal age at first childbirth below 20 years a risk factor?

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