Under-Five Child Mortality and Morbidity Associated with Consanguineous Child Marriage in Pakistan: Retrospective Analysis using Pakistan Demographic and Health Surveys, 1990–91, 2006–07, 2012–13
Tóm tắt
Objective To assess the combined effect of consanguineous and child marriages (CCM) on children health, which has not previously been explored, either globally or locally. Methods We analyzed secondary data from a series of cross-sectional, nationally representative Pakistan Demographic and Health Surveys 1990–91, 2006–07, and 2012–13. A total of 5406 mothers with 10,164 children were included in the analysis. Child health was assessed by variables such as history of diarrhea, acute respiratory infection (ARI), ARI with fever, Under-5 child mortality (U5CM) and small-size birth (SSB). Associations among variables were assessed by calculating unadjusted Odd Ratios (OR) and adjusted OR (AOR). Results A majority (n = 6,247, 61%) of the births were to mothers having CCM as compare to non-CCM (3917, 39%). There was a significant association between CCM and U5CM during 1990–91 (AOR 1.24, 95% CI 1.03–1.49) and 2006–07 (AOR 1.25, 95% CI 1.05–1.51), and infant mortality in 1990–91 (AOR 1.39, 95% CI 1.05–1.85) and 2006–07 (AOR 1.61, 95% CI 1.17–2.21). A significant association was also found between CCM and SSB infants in the period 2006–07 (AOR 1.19, 95% CI 1.01–1.42) and 2012–13 (AOR 1.22, 95% CI 1.02–1.46). We noted no effect of CCM on diarrhea, ARI, and ARI with fever. Conclusion CCM increases the likelihood of U5CM, infant mortality and SSB infants. Further quantitative and qualitative research should be conducted to assess the effects of environmental, congenital and genetic factors on the health of children born to mothers in CCM.
Tài liệu tham khảo
Bener, A., & Hussain, R. (2006). Consanguineous unions and child health in the State of Qatar. Pediatrics and Perinatal Epidemiology, 20, 372–378.
Bhutta, Z. A., Gupta, I., de’Silva, H., Manandhar, D., Awasthi, S., Moazzem Hossain, S. M., et al. (2004). Maternal and child health: Is South Asia ready for change? British Medical Journal, 328, 816–819.
Bildirici, M., Ersin, O. M., & Kokdener, M. (2010). Genetic structure, consanguineous marriages and economic development: Panel cointegration and panel cointegration neural network analyses. Expert Systems with Applications, 38(5), 6153–6163.
Bittles, A. H. (2003). Consanguineous marriage and childhood health. Developmental Medicine and Child Neurology, 45, 571–576.
Bittles, A. H., & Black, M. L. (2010a). Consanguinity, human evolution and complex diseases. Proceedings of the National Academy Science USA, 107, 1779–1786.
Bittles, A. H., & Black, M. L. (2010b). The impact of consanguinity on neonatal and infant health. Early Human Development, 86, 737–741.
Demographic and Health Survey (DHS) Program (2014). http://www.dhsprogram.com/. Accessed 10 July 2014.
Edmon, K., Bahl, R. (2006). Optimal feeding of low-birth-weight infants. World Health Organization. http://whqlibdoc.who.int/publications/2006/9789241595094_eng.pdf. Accessed 10 July 2014.
Güler, Ö. & Küçüker, H. (2010). Early Marriages Among Adolesencent Girls in Afyonkarahisar, Turkey. Journal of General Medicine, 7(4), 365–371 (European).
Gulzar, H., Michael, B., & Brian, L. (1998). Consanguinity and child mortality; the risk faced by families. Population Research and Policy Review Research, 17(3), 275–283.
Hamamy, H. (2011). Consanguineous marriages Preconception consultation in primary health care settings. Journal of Community Genetics, 3, 185–192.
Hamamy, H., et al. (2011). Consanguineous marriages, pearls and perils: Geneva International Consanguinity Workshop report. Genetics in Medicine, 13, 841–847.
Hussain R. (1998). The role of consanguinity and inbreeding as determinant of spontaneous abortion in Karachi, Pakistan. Annals of Human Genetics, 62, 147–157.
Hussain, R., Bittles, A. H., & Sullivan, S. (2001). Consanguinity and early mortality in the Muslim populations of India and Pakistan. American Journal of Human Biology, 13, 177–187.
International Council for Research on Women (ICRW) (2007a). New insights on preventing child marriage: a global analysis of factors and programs. http://www.icrw.org/files/publications/New-Insights-on- Preventing-Child-Marriage.pdf. Accessed 10 July 2014.
International Council for Research on Women (ICRW) (2007b). New insights on preventing child marriage: a global analysis of factors and programs. http://www.icrw.org/files/publications/New-Insights-on- Preventing-Child-Marriage.pdf. Accessed 10 Nov 2014.
Mayor, S. (2004). Pregnancy and childbirth are leading causes of death in teenage girls in developing countries. British Medical Journal, 328, 1152.
Modell, B., & Dar, A. (2002). Genetic counseling and customary consanguineous marriage. Science and Society Journal, 3, 225–229.
Mohammadi, M. M., Hooman, H. A., Afrooz, G. A., & Daramadi, P. S. (2012). The relationship between consanguineous marriage and death in fetus and infants. Journal of Research in Medical Sciences, 17(5), 448–451.
Mumtaz, G., et al. (2007). Effect of consanguinity on birth weight for gestational age in a developing country. American Journal of Epidemiology, 165(7), 742–752.
Nasrullah, M., Muazzam, S., Bhutta, Z. A., & Raj, A. (2014). Girl child marriage and its effect on fertility in Pakistan: Findings from Pakistan Demographic and Health Survey Data, 2006–07. Maternal and Child Health Journal, 18(3), 534–543.
Nasrullah, M., Zakar, R., & Zakar, M. Z. (2014a). Child marriage and its associations with controlling behaviors and spousal violence against adolescent and young women in Pakistan. The Journal of Adolescent Health, 55(6), 804–809.
Nasrullah, M., Zakar, R., Zakar, M. Z., & Kramer, A. (2014b). Girl-child marriage and its association with morbidity and mortality of children under 5 years of age in a nationally representative sample of Pakistan. The Journal of Pediatrics, 164(3), 639–646.
National Institute of Population Studies (NIPS) (1992). [Pakistan] and Macro International Inc. Pakistan Demographic and Health Survey 1990-91. Islamabad, Pakistan: National Institute of Population Studies and Macro International Inc. https://dhsprogram.com/pubs/pdf/FR29/FR29.pdf. Accessed 10 June 2014.
National Institute of Population Studies (NIPS) (2008). [Pakistan] and Macro International Inc. Pakistan Demographic and Health Survey 2006-07. Islamabad, Pakistan: National Institute of Population Studies and Macro International Inc. https://dhsprogram.com/pubs/pdf/FR200/FR200.pdf. Accessed 10 June 2014.
National Institute of Population Studies (NIPS) (2013). [Pakistan] and Macro International Inc. Pakistan Demographic and Health Survey 2012-13. Islamabad, Pakistan: National Institute of Population Studies and Macro International Inc. https://dhsprogram.com/pubs/pdf/FR290/FR290.pdf. Accessed 10 June 2014.
Obeidat, B. R., et al. (2010). Consanguinity and adverse pregnancy outcomes: The North of Jordan experience. Maternal and Child Health Journal, 14(2), 283–289.
Raj, A., Saggurti, N., Winter, M., Labonte, A., Decker, M. R., Balaiah, D., et al. (2010). The effect of maternal child marriage on morbidity and mortality of children under 5 in India: Cross sectional study of a nationally representative sample. BMJ, 340, b4258.
Ramakrishnan, U. (2004). Nutrition and low birth weight: from research to practice. American Society for Clinical Nutrition, 79(1), 17–21.
Sivaram, M., Richard, J., & Rao, P. S. (1995). Early marriage among rural and urban females of south India. Journal of Biosocial Science, 27(3), 325–331.
Stoltenberg, C., Magnus, P., Lie, R. T., Daltveit, A. K., & Irgens, L. M. (1997). Birth defects and parental consanguinity in Norway. American Journal of Epidemiology, 145, 439–448.
Stoltenberg, C., Magnus, P., Skrondal, A., & Lie, R. T. (1999). Consanguinity and Recurrence Risk of Stillbirth and Infant Death. American Journal of Public Health, 89, 517–523.
UNICEF (2015). Progress report: Six headline results for children in South Asia, end child marriage. http://www.unicef.org/rosa/4-PR-childmarriage.pdf. Accessed 11 Sept 2016.
United Nation Population Fund (UNPF) (2014). Girl Summit aims to end child marriage and FGM/C. http://www.unfpa.org/public/cache/offonce/home/news/pid/17906;jsessionid=25129E2766DD6F421245D6DC405EDB5C.jahia02#sthash.McMKLeME.dpuf. Accessed 12 Sept 2014.
United Nations Children’s Fund (UNICEF) (2013). Levels and trends in child mortality: Estimates Developed by the UN Inter-agency Group for Child Mortality Estimation. http://www.childinfo.org/files/Child_Mortality_Report_2013.pdf.
United Nations Children’s Fund (2015). Levels & trends in child: Report 2015, estimates developed by the UN Inter-agency Group for Child Mortality Estimation Mortality. http://www.childmortality.org/files_v20/download/IGME%20report%202015%20child%20mortality%20final.pdf. Accessed 3 Sept 2016.
United Nations Development Programme (UNDP) (2016). Reduce child mortality where we are?: Overall progress on Pakistan’s MDGs. http://www.pk.undp.org/content/pakistan/en/home/post-2015/mdgoverview/overview/mdg4/.
United States Agency for International Development (USAID) (2011). Women’s empowerment in Pakistan: a scoping study, Gender Equity Program (GEP) of Aurat Foundation. http://www.af.org.pk/gep/deskStudies/Women_s%20Empowerment.pdf. Accessed 10 July 2014.
United States Agency for International Development (USAID) (2014). Ending child marriage & meeting the needs of married children: The USAID vision for action. http://pdf.usaid.gov/pdf_docs/PDACU300.pdf. Accessed 10 July 2014.
Williams, B. G., Gouws, E., Boschi-Pinto, C., Bryce, J., & Dye, C. (2002). Estimates of world wide distribution of child deaths from acute respiratory infections. The Lancet Infectious Diseases, 2, 25–32.
Zakar R., Zakar, M. Z. & Aqil N. (2014). Adverse birth outcomes associated with consanguineous marriage in Pakistan. International Journal of Gynecology and Obstetrics, 127(2), 211–212.
