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Post-neonatal infant mortality in Malawi: the importance of maternal health

Verhoeff, Francine H., Le Cessie, S., Kalanda, Boniface F., Kazembe, P. N., Broadhead, R. L. and Brabin, Bernard (2004) 'Post-neonatal infant mortality in Malawi: the importance of maternal health'. Annals of Tropical Paediatrics, Vol 24, Issue 2, pp. 161-169.

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Abstract

In a cohort study of mothers and their infants, information was collected from women attending the antenatal services of two hospitals in a rural area of Malawi and 561 of their babies were enrolled in a follow-up study. There were 128 with a low birthweight (LBW, <2500 g), 138 with fetal anaemia (FA, cord haemoglobin < 12.5 g/dl), 42 with both and 228 with a normal birthweight and no FA. Infants were seen monthly for 1 year. Risk factors for post-neonatal infant mortality (PNIM) were calculated using Cox regression analysis adjusting for LBW and FA. PNIM was 9.3%. Respiratory infections and diarrhoeal disease were the principal attributable causes of death. PNIM increased with LBW (RR 3.08, 95% CI 1.51-6.23) but not significantly so with FA (RR 1.60, 95% CI 0.78-3.27). An additional effect on PNIM was observed with maternal HIV (RR 3.44, 95%, CI 1.63-7.26) and malaria at the first antenatal visit (RR 2.26, 95% CI 1.09-4.73). Illiteracy was not associated with mortality. Placental malaria in HIV-seronegative mothers was significantly associated with increased PNIM. Improving birthweight through effective antimalarial control in pregnancy will lead to a reduction in PNIM. Reduction of HIV prevalence and prevention of mother-to-child transmission of HIV must be a main target for government health policy.

Item Type: Article
Uncontrolled Keywords: immunodeficiency-virus type-1 to-child transmission low-birth-weight rural malawi seropositive women pregnant-women young-children risk-factors viral load malaria
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare
WA Public Health > Statistics. Surveys > WA 900 Public health statistics
WS Pediatrics > WS 20 Research (General)
Faculty: Department: Groups (2002 - 2012) > Child & Reproductive Health Group
Digital Object Identifer (DOI): https://doi.org/10.1179/027249304225013448
Related URLs:
Depositing User: Ms Julia Martin
Date Deposited: 07 Mar 2012 11:38
Last Modified: 06 Feb 2018 13:03
URI: https://archive.lstmed.ac.uk/id/eprint/2121

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