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The impact of antenatal care, iron–folic acid supplementation and tetanus toxoid vaccination during pregnancy on child mortality in Bangladesh
BACKGROUND: Appropriate antenatal care (ANC) is an important preventive public health intervention to ensure women’s and newborn health outcomes. The study aimed to investigate the impact of ANC, iron–folic acid (IFA) supplementation and tetanus toxoid (TT) vaccination during pregnancy on child mort...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5665518/ https://www.ncbi.nlm.nih.gov/pubmed/29091923 http://dx.doi.org/10.1371/journal.pone.0187090 |
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author | Abir, Tanvir Ogbo, Felix Akpojene Stevens, Garry John Page, Andrew Nicolas Milton, Abul Hasnat Agho, Kingsley Emwinyore |
author_facet | Abir, Tanvir Ogbo, Felix Akpojene Stevens, Garry John Page, Andrew Nicolas Milton, Abul Hasnat Agho, Kingsley Emwinyore |
author_sort | Abir, Tanvir |
collection | PubMed |
description | BACKGROUND: Appropriate antenatal care (ANC) is an important preventive public health intervention to ensure women’s and newborn health outcomes. The study aimed to investigate the impact of ANC, iron–folic acid (IFA) supplementation and tetanus toxoid (TT) vaccination during pregnancy on child mortality in Bangladesh. METHOD: A cross-sectional study of three datasets from the Bangladesh Demographic and Health Surveys for the years 2004, 2007 and 2011 were pooled and used for the analyses. A total weighted sample of 16,721 maternal responses (5,364 for 2004; 4,872 for 2007 and 6,485 for 2011) was used. Multivariate logistic models that adjusted for cluster and sampling weights were used to examine the impact of ANC, IFA supplementation and TT vaccination during pregnancy on the death of a child aged 0–28 days (neonatal), 1–11 months (post-neonatal) and 12–59 months (child). RESULTS: Multivariable analyses revealed that the odds of postnatal and under-5 mortality was lower in mothers who had ANC [Odds Ratio (OR) = 0.60, 95% confidence interval (95% CI): 0.43–0.85], IFA supplementation [OR = 0.66, 95% CI: (0.45–0.98)] and ≥2 TT vaccinations (OR = 0.43, 95% CI: 0.49–0.78) for post-natal mortality; and for under-5 mortality, any form of ANC (OR = 0.69, 95% CI: 0.51–0.93), IFA supplementation (OR = 0.67, 95% CI: 0.48–0.94) and ≥2 TT vaccinations (OR = 0.50, 95% CI: 0.36–0.69). When combined, TT vaccination with IFA supplementation, and TT vaccination without IFA supplementation were protective across all groups. CONCLUSION: The study found that ANC, IFA supplementation, and TT vaccination during pregnancy reduced the likelihood of child mortality in Bangladesh. The findings suggest that considerable gains in improving child survival could be achieved through ensuring universal coverage of ANC, promoting TT vaccination during pregnancy and IFA supplementation among pregnant women in Bangladesh. |
format | Online Article Text |
id | pubmed-5665518 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-56655182017-11-09 The impact of antenatal care, iron–folic acid supplementation and tetanus toxoid vaccination during pregnancy on child mortality in Bangladesh Abir, Tanvir Ogbo, Felix Akpojene Stevens, Garry John Page, Andrew Nicolas Milton, Abul Hasnat Agho, Kingsley Emwinyore PLoS One Research Article BACKGROUND: Appropriate antenatal care (ANC) is an important preventive public health intervention to ensure women’s and newborn health outcomes. The study aimed to investigate the impact of ANC, iron–folic acid (IFA) supplementation and tetanus toxoid (TT) vaccination during pregnancy on child mortality in Bangladesh. METHOD: A cross-sectional study of three datasets from the Bangladesh Demographic and Health Surveys for the years 2004, 2007 and 2011 were pooled and used for the analyses. A total weighted sample of 16,721 maternal responses (5,364 for 2004; 4,872 for 2007 and 6,485 for 2011) was used. Multivariate logistic models that adjusted for cluster and sampling weights were used to examine the impact of ANC, IFA supplementation and TT vaccination during pregnancy on the death of a child aged 0–28 days (neonatal), 1–11 months (post-neonatal) and 12–59 months (child). RESULTS: Multivariable analyses revealed that the odds of postnatal and under-5 mortality was lower in mothers who had ANC [Odds Ratio (OR) = 0.60, 95% confidence interval (95% CI): 0.43–0.85], IFA supplementation [OR = 0.66, 95% CI: (0.45–0.98)] and ≥2 TT vaccinations (OR = 0.43, 95% CI: 0.49–0.78) for post-natal mortality; and for under-5 mortality, any form of ANC (OR = 0.69, 95% CI: 0.51–0.93), IFA supplementation (OR = 0.67, 95% CI: 0.48–0.94) and ≥2 TT vaccinations (OR = 0.50, 95% CI: 0.36–0.69). When combined, TT vaccination with IFA supplementation, and TT vaccination without IFA supplementation were protective across all groups. CONCLUSION: The study found that ANC, IFA supplementation, and TT vaccination during pregnancy reduced the likelihood of child mortality in Bangladesh. The findings suggest that considerable gains in improving child survival could be achieved through ensuring universal coverage of ANC, promoting TT vaccination during pregnancy and IFA supplementation among pregnant women in Bangladesh. Public Library of Science 2017-11-01 /pmc/articles/PMC5665518/ /pubmed/29091923 http://dx.doi.org/10.1371/journal.pone.0187090 Text en © 2017 Abir et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Abir, Tanvir Ogbo, Felix Akpojene Stevens, Garry John Page, Andrew Nicolas Milton, Abul Hasnat Agho, Kingsley Emwinyore The impact of antenatal care, iron–folic acid supplementation and tetanus toxoid vaccination during pregnancy on child mortality in Bangladesh |
title | The impact of antenatal care, iron–folic acid supplementation and tetanus toxoid vaccination during pregnancy on child mortality in Bangladesh |
title_full | The impact of antenatal care, iron–folic acid supplementation and tetanus toxoid vaccination during pregnancy on child mortality in Bangladesh |
title_fullStr | The impact of antenatal care, iron–folic acid supplementation and tetanus toxoid vaccination during pregnancy on child mortality in Bangladesh |
title_full_unstemmed | The impact of antenatal care, iron–folic acid supplementation and tetanus toxoid vaccination during pregnancy on child mortality in Bangladesh |
title_short | The impact of antenatal care, iron–folic acid supplementation and tetanus toxoid vaccination during pregnancy on child mortality in Bangladesh |
title_sort | impact of antenatal care, iron–folic acid supplementation and tetanus toxoid vaccination during pregnancy on child mortality in bangladesh |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5665518/ https://www.ncbi.nlm.nih.gov/pubmed/29091923 http://dx.doi.org/10.1371/journal.pone.0187090 |
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