History of Pregnancy-Loss and Maternal Socioeconomic Factors as Predictors of Under-Five Child Mortality

Nigeria is one of the countries with the highest Under-5 Mortality rates (U5M) estimated at 117 deaths/1000 live births. Despite public health control initiatives, no significant improvement in U5M has been demonstrated. The purpose of the study was to determine whether history of Adverse Pregnancy Outcomes (APO) and maternal socioeconomic factors could predict the death of children before their fifth birthday, using the life course health development and fetal programming theories. The study population was women in their reproductive age (15- 49 years). The study was a secondary data analysis of the datasets obtained from three Nigeria Demographic and Health Surveys (2003, 2008, and 2013). Complex samples multivariate logistic regression was used to determine the associations among variables. The results showed that lower education level (p \u3c 0.001), lower income level (p \u3c0.05), rural residential setting (p\u3c 0.01), and lower socioeconomic status index (p \u3c 0.001) of women were statistically significant predictors of U5M. APO was not statistically associated with U5M (p \u3e 0.05). This concludes that children of women with low socioeconomic factors and status index could be at higher risk of death within the first 5 years of their lives, and women with history of APO stand no greater risk of losing their under-5 children. The study would contribute to positive social change among women in Nigeria through early identification of women whose children may be at risk of U5M and provision of evidence-based advocacy to urge increased government and public attention to women and child welfare

Do Adverse Pregnancy Outcomes Predict Under-Five Mortality in Nigeria?

Nigerian children under 5 years of age are over 15 times more at risk of death than their counterparts in developed regions of the world; the prevalence of miscarriage, an adverse pregnancy outcome (APO), was estimated at 49%. In the present study, the relationship between APO and under-5 mortality (U5M) in Nigeria was examined to determine if APO could be used as a reliable early warning indicator for U5M. We used a cross-sectional secondary data analysis of datasets from three Nigeria demographic and health surveys: 2003, 2008, and 2013. The study population was women of reproductive age (15–49). Cochran–Mantel–Haenzel chi-square statistics and multiple logistic regression were performed to determine the association, based on maternal socioeconomic factors and access to prenatal healthcare. Results indicated a significant inverse association between APO and U5M. The children of women who have experienced any form of APO may be at lower risk of U5M than children of women who have never had any APO. The implication is that history of APO may not be a reliable early warning indicator for determining higher risk of U5M. These findings suggest further studies to explore the pathway of this association