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A population-based study of effect of multiple birth on infant mortality in Nigeria.

Uthman OA, Uthman MB, Yahaya I - BMC Pregnancy Childbirth (2008)

Bottom Line: Maternal education and household asset index were associated with lower risk of infant mortality.Multiple births are strongly negatively associated with infant survival in Nigeria independent of other risk factors.A well-educated mother has a better chance of satisfying important factors that can improve infant survival: the quality of infant feeding, general care, household sanitation, and adequate use of preventive and curative health services.

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Affiliation: Center for Evidence-Based Global Health, Ilorin, Kwara State, Nigeria. uthlekan@yahoo.com

ABSTRACT

Background: Multi-foetal pregnancies and multiple births including twins and higher order multiples births such as triplets and quadruplets are high-risk pregnancy and birth. These high-risk groups contribute to the higher rate of childhood mortality especially during early period of life.

Methods: We examined the relationship between multiple births and infant mortality using univariable and multivariable survival regression procedure with Weibull hazard function, controlling for child's sex, birth order, prenatal care, delivery assistance; mother's age at child birth, nutritional status, education level; household living conditions and several other risk factors.

Results: Children born multiple births were more than twice as likely to die during infancy as infants born singleton (hazard ratio = 2.19; 95% confidence interval: 1.50, 3.19) holding other factors constant. Maternal education and household asset index were associated with lower risk of infant mortality.

Conclusion: Multiple births are strongly negatively associated with infant survival in Nigeria independent of other risk factors. Mother's education played a protective role against infant death. This evidence suggests that improving maternal education may be key to improving child survival in Nigeria. A well-educated mother has a better chance of satisfying important factors that can improve infant survival: the quality of infant feeding, general care, household sanitation, and adequate use of preventive and curative health services.

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Probability of survival before 12 months of age by birth status, Nigeria 2003.
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Figure 1: Probability of survival before 12 months of age by birth status, Nigeria 2003.

Mentions: For children born in the five years preceding the NDHS, the survival probabilities for children born singleton and multiple-birth by single months of age before 12 months was presented in Figure 1. The figure shows that the two survival curves diverge beyond the second month of age, with children born multiple-birth having progressively lower survival probability than children born singleton. The difference in survival probability between children born singleton and multiple-birth was non-random as judge by log-rank test of survival functions (chi-squared = 16.01 on one degree of freedom; p = .001). The large majority of multiple birth children died in infancy.


A population-based study of effect of multiple birth on infant mortality in Nigeria.

Uthman OA, Uthman MB, Yahaya I - BMC Pregnancy Childbirth (2008)

Probability of survival before 12 months of age by birth status, Nigeria 2003.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2551580&req=5

Figure 1: Probability of survival before 12 months of age by birth status, Nigeria 2003.
Mentions: For children born in the five years preceding the NDHS, the survival probabilities for children born singleton and multiple-birth by single months of age before 12 months was presented in Figure 1. The figure shows that the two survival curves diverge beyond the second month of age, with children born multiple-birth having progressively lower survival probability than children born singleton. The difference in survival probability between children born singleton and multiple-birth was non-random as judge by log-rank test of survival functions (chi-squared = 16.01 on one degree of freedom; p = .001). The large majority of multiple birth children died in infancy.

Bottom Line: Maternal education and household asset index were associated with lower risk of infant mortality.Multiple births are strongly negatively associated with infant survival in Nigeria independent of other risk factors.A well-educated mother has a better chance of satisfying important factors that can improve infant survival: the quality of infant feeding, general care, household sanitation, and adequate use of preventive and curative health services.

View Article: PubMed Central - HTML - PubMed

Affiliation: Center for Evidence-Based Global Health, Ilorin, Kwara State, Nigeria. uthlekan@yahoo.com

ABSTRACT

Background: Multi-foetal pregnancies and multiple births including twins and higher order multiples births such as triplets and quadruplets are high-risk pregnancy and birth. These high-risk groups contribute to the higher rate of childhood mortality especially during early period of life.

Methods: We examined the relationship between multiple births and infant mortality using univariable and multivariable survival regression procedure with Weibull hazard function, controlling for child's sex, birth order, prenatal care, delivery assistance; mother's age at child birth, nutritional status, education level; household living conditions and several other risk factors.

Results: Children born multiple births were more than twice as likely to die during infancy as infants born singleton (hazard ratio = 2.19; 95% confidence interval: 1.50, 3.19) holding other factors constant. Maternal education and household asset index were associated with lower risk of infant mortality.

Conclusion: Multiple births are strongly negatively associated with infant survival in Nigeria independent of other risk factors. Mother's education played a protective role against infant death. This evidence suggests that improving maternal education may be key to improving child survival in Nigeria. A well-educated mother has a better chance of satisfying important factors that can improve infant survival: the quality of infant feeding, general care, household sanitation, and adequate use of preventive and curative health services.

Show MeSH
Related in: MedlinePlus