TY - JOUR
T1 - Country-level analysis of the association between maternal obesity and neonatal mortality in 34 Sub-Saharan African countries
AU - Ozodiegwu, Ifeoma D.
AU - Mamudu, Hadii M.
AU - Wang, Liang
AU - Wallace, Richard
AU - Quinn, Megan
AU - Liu, Ying
AU - Doctor, Henry V.
N1 - Publisher Copyright:
© 2019 The Author(s).
PY - 2019
Y1 - 2019
N2 - Background: Prior work examining the association of maternal obesity and neonatal mortality indicate the presence of a positive relationship. However, regional evidence to provide insight on country-level heterogeneities within sub-Saharan Africa (SSA) with nationally representative datasets are non-existent. Objective: We aimed to determine the relationship between maternal obesity and neonatal mortality at the country level in SSA countries. Moreover, we also estimate regional measures of association to complement previous findings. Methods: Demographic and Health Survey (DHS) data from 34 SSA countries conducted from 2006–2016 were used for this study. After missing data (36.9% of cases) were addressed with multiple imputations, we identified a total of 175,860 women for the analysis. Complete case and multiply imputed datasets were analyzed individually with multilevel logistic regression models. Potential confounders adjusted for in the regression model included maternal age, level of educational attainment, area of residence, access to prenatal care, birth order and multiple birth (singleton vs twin birth). Regional and country-specific associations were computed, and unadjusted and adjusted odds ratios (ORs), along with the confidence intervals (CIs) were reported. Findings: Of the total study population, 8,451 (7.6%) were obese. In the regional level analyses, maternal obesity was associated with 40% increased odds of neonatal deaths. This finding was consistent in subgroup analyses by urban and rural residence, and geographic region of residence in SSA. Additionally, obese women were more likely to report neonatal death in the first week of life (OR, days 0–1: 1.39, 95% CI 1.15–1.69; OR, days 2–6: 1.35, 95% CI 1.02–1.79). In the individual country analyses, majority of the countries studied had central estimates supporting elevated odds of neonatal mortality, but the confidence intervals were imprecise. Conclusion: This study highlights the potential burden of neonatal mortality borne by obese women in SSA. There is, however, a need for longitudinal studies to confirm the results.
AB - Background: Prior work examining the association of maternal obesity and neonatal mortality indicate the presence of a positive relationship. However, regional evidence to provide insight on country-level heterogeneities within sub-Saharan Africa (SSA) with nationally representative datasets are non-existent. Objective: We aimed to determine the relationship between maternal obesity and neonatal mortality at the country level in SSA countries. Moreover, we also estimate regional measures of association to complement previous findings. Methods: Demographic and Health Survey (DHS) data from 34 SSA countries conducted from 2006–2016 were used for this study. After missing data (36.9% of cases) were addressed with multiple imputations, we identified a total of 175,860 women for the analysis. Complete case and multiply imputed datasets were analyzed individually with multilevel logistic regression models. Potential confounders adjusted for in the regression model included maternal age, level of educational attainment, area of residence, access to prenatal care, birth order and multiple birth (singleton vs twin birth). Regional and country-specific associations were computed, and unadjusted and adjusted odds ratios (ORs), along with the confidence intervals (CIs) were reported. Findings: Of the total study population, 8,451 (7.6%) were obese. In the regional level analyses, maternal obesity was associated with 40% increased odds of neonatal deaths. This finding was consistent in subgroup analyses by urban and rural residence, and geographic region of residence in SSA. Additionally, obese women were more likely to report neonatal death in the first week of life (OR, days 0–1: 1.39, 95% CI 1.15–1.69; OR, days 2–6: 1.35, 95% CI 1.02–1.79). In the individual country analyses, majority of the countries studied had central estimates supporting elevated odds of neonatal mortality, but the confidence intervals were imprecise. Conclusion: This study highlights the potential burden of neonatal mortality borne by obese women in SSA. There is, however, a need for longitudinal studies to confirm the results.
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U2 - 10.5334/aogh.2510
DO - 10.5334/aogh.2510
M3 - Article
C2 - 31857945
AN - SCOPUS:85077152327
VL - 85
JO - Mount Sinai Journal of Medicine
JF - Mount Sinai Journal of Medicine
SN - 2214-9996
IS - 1
M1 - 139
ER -