International journal of epidemiology · 1996
Maternal determinants of child survival in a rural African community.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Van den Broeck J, Eeckels R, Massa G
Аннотация
BACKGROUND: The aim was to determine maternal factors related to child survival in the rural area of Bwamanda, Northern Zaire.
METHODS: A prospective study of 30-months mortality was carried out in a cohort of 776 children aged 0-3 months, obtained by random cluster sampling. Inclusion criteria were exclusive breastfeeding, no severe prematurity and absence of severe protein-energy malnutrition, diarrhoea or acute respiratory infection. Mortality was recorded by regular home visits and inspection of hospital and funeral registers. Maternal factors that remain stable during follow-up were studied.
RESULTS: Factors associated with excess mortality in bivariate and multiple logistic regression analysis were: (i) mother has parity > 5 (relative risk [RR] = 1.5-4.2); (ii) distance from the health centre > 5 km (RR = 0.9-2.9); (iii) invaliding maternal diseases (RR = 1.2-9.0). Maternal school education (conditional odds ratio [OR] = 1.0-5.0) was significant in the multiple regression. In contrast to the other risk factors, mother-child separation or problems with breastfeeding were rare and did not significantly increase mortality.
CONCLUSIONS: Chronic stress situations created by maternal invalidity, high parity and distance from health care facilities, increase child mortality. Acute stress in the mother-child dyad seemed to be efficiently compensated for. In subsistence economy areas, maternal school education can be a disadvantage.
METHODS: A prospective study of 30-months mortality was carried out in a cohort of 776 children aged 0-3 months, obtained by random cluster sampling. Inclusion criteria were exclusive breastfeeding, no severe prematurity and absence of severe protein-energy malnutrition, diarrhoea or acute respiratory infection. Mortality was recorded by regular home visits and inspection of hospital and funeral registers. Maternal factors that remain stable during follow-up were studied.
RESULTS: Factors associated with excess mortality in bivariate and multiple logistic regression analysis were: (i) mother has parity > 5 (relative risk [RR] = 1.5-4.2); (ii) distance from the health centre > 5 km (RR = 0.9-2.9); (iii) invaliding maternal diseases (RR = 1.2-9.0). Maternal school education (conditional odds ratio [OR] = 1.0-5.0) was significant in the multiple regression. In contrast to the other risk factors, mother-child separation or problems with breastfeeding were rare and did not significantly increase mortality.
CONCLUSIONS: Chronic stress situations created by maternal invalidity, high parity and distance from health care facilities, increase child mortality. Acute stress in the mother-child dyad seemed to be efficiently compensated for. In subsistence economy areas, maternal school education can be a disadvantage.