Comparative analysis of patterns of survival by season of birth in rural Bangladeshi and Gambian populations
Comparative analysis of patterns of survival by season of birth in rural Bangladeshi and Gambian populations
复制标题
DOI：
10.1093/ije/dyh007
复制
发表时间：
2004-02-01
影响因子：
7.7
通讯作者：
Prentice, AM
中科院分区：
文献类型：
--
作者：
Moore, SE;Fulford, AJC;Prentice, AM
背景：以前对冈比亚农村地区的数据进行的分析表明，在每年的饥饿季节出生，可能通过对免疫功能的影响，极大地影响了青年期传染病死亡的易感性。在孟加拉国农村，怀孕也受到类似的季节性影响。目前的论文使用了来自孟加拉国Matlab地区的一项大型人口调查的数据，以重新验证冈比亚的假设，即早期生活暴露与出生季节相关，可以预测后来的死亡率模式。方法自1966年以来，在孟加拉国Matlab农村地区建立了连续的人口监测系统。目前的分析是基于1974年至2000年期间的172 228例出生和24 697例死亡。根据同一数据集内受孕率和新生儿死亡率的月度变化，将出生季节定义为“收获”（1月至6月）和“饥饿”（7月至12月）。结果饥饿季节出生的婴儿在出生后第一年的死亡率较高。然而，对于成人死亡率（15岁以下死亡），每年饥饿季节出生的个体没有增加：7月至12月与1月至6月的危害比= 1.12；95% ci: 0.87, 1.45。目前的研究发现，在孟加拉国农村“饥饿”季节出生的年轻人没有过高的死亡率。与冈比亚相比，这种不同的生存模式可能是由于孟加拉国青年死亡率（0.1%）大大低于冈比亚（3%）。在这种情况下，可能无法检测到免疫功能的差异，从而导致成人早期死亡。然而，我们在冈比亚的观察也可能是一种高度离散的现象，在时间或地点上都是局部的，因此，在其他人群中不会被复制。
Background Analysis of data from rural Gambia has previously shown that being born during the annual hungry season strongly influences susceptibility to mortality from infectious disease in young adulthood, possibly through an influence on immune function. In rural Bangladesh pregnancies are exposed to similar seasonality. The current paper uses data from a large demographic survey in the Matlab region of Bangladesh to retest the Gambian-derived hypothesis that early life exposures correlated with season of birth predict later patterns of mortality.Methods Since 1966, a continuous demographic surveillance system has been in operation in the rural Matlab region of Bangladesh. The current analysis is based on 172 228 births and 24 697 deaths between 1974 and 2000. Season of birth was defined as 'harvest' (January-June) and 'hungry' (July-December), based on monthly variations in rates of conception and neonatal mortality within the same dataset.Results Birth during the hungry season resulted in excess mortality during the first year of life. However, for adult mortality (deaths >15 years), there was no excess in individuals born during the annual hungry season: ratio of hazard July-December versus January-June = 1.12; 95% CI: 0.87, 1.45.Conclusions The current study found no excess mortality in young adults born during the 'hungry' season in rural Bangladesh. This differing pattern in survival when compared with The Gambia may be a consequence of the greatly reduced incidence of young adult deaths in Bangladesh (0.1%) compared with The Gambia (3%). Under such conditions possible differences in immune function may not be detectable with early adult death as the outcome. However, it also remains possible that our Gambian observation could be a highly discrete phenomenon localized in either time or place, and as such, will not be replicated in other populations.