Effects of Birth Month on Child Health and Survival in Sub-Saharan Africa
Effects of Birth Month on Child Health and Survival in Sub-Saharan Africa
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DOI：
10.1080/19485565.2015.1032399
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发表时间：
2015-05-04
影响因子：
1.3
通讯作者：
Dorelien, Audrey M.
中科院分区：
文献类型：
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作者：
Dorelien, Audrey M.
在撒哈拉以南非洲 (SSA) 的大部分地区，出生月份可以广泛预测 5 岁以下儿童死亡率和发育迟缓情况。母亲的出生年龄、受教育程度等观察因素与出生月份相关，但并不是出生月份与儿童健康关系的主要因素。在许多撒哈拉以南非洲国家，通过固定效应模型考虑母亲选择削弱了出生月份与健康之间的关系。在其余国家，出生月份的影响可能受到环境因素的调节。这项研究发现，出生月份对死亡率的影响通常不会因年龄间隔而变化；按出生月份划分的死亡率差异在新生儿期很明显，并且在不同年龄阶段持续存在。出生时的男女性别比例并不因出生月份而变化，这表明子宫内暴露不会影响胎儿流产，因此出生月份的影响不太可能是子宫内选择性生存的结果。在三分之一的样本中，出生月份对发育迟缓的影响在 2 岁后减弱；因此，一些孩子能够赶上。改善儿童健康的政策应针对孕妇和婴儿，并且必须考虑季节性。
Birth month is broadly predictive of both under-5 mortality rates and stunting throughout most of sub-Saharan Africa (SSA). Observed factors, such as mother's age at birth and educational status, are correlated with birth month but are not the main factors underlying the relationship between birth month and child health. Accounting for maternal selection via a fixed-effects model attenuates the relationship between birth month and health in many SSA countries. In the remaining countries, the effect of birth month may be mediated by environmental factors. This study found that birth month effects on mortality typically do not vary across age intervals; the differential mortality rates by birth month are evident in the neonatal period and continue across age intervals. The male-to-female sex ratio at birth did not vary by birth month, which suggests that in utero exposures are not influencing fetal loss, and that therefore the birth month effects are not likely a result of selective survival during the in utero period. In one-third of the sample, the birth month effects on stunting diminished after the age of 2 years; therefore, some children were able to catch up. Policies to improve child health should target pregnant women and infants and must take seasonality into account.