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Siblings' neonatal mortality risks and birth spacing in Bangladesh
1Princeton University, Office of Population Research, NJ 08544.
Insights
Sibling mortality risk is linked within families, especially for adjacent birth orders. Optimal birth spacing significantly impacts neonatal mortality, particularly when the prior child survives.
Area of Science:
- Demography
- Epidemiology
- Biostatistics
Background:
- Neonatal mortality remains a significant global health challenge.
- Understanding familial aggregation and birth spacing is crucial for targeted interventions.
- Previous studies have not fully explored the interplay of these factors in specific populations.
Purpose of the Study:
- To investigate the familial association of neonatal mortality in Matlab, Bangladesh.
- To examine the relationship between birth spacing and neonatal mortality.
- To compare different statistical models for analyzing correlated survival data.
Main Methods:
- Utilized data from Matlab, Bangladesh, to study neonatal mortality patterns.
- Employed transitional (Markov), random-effects, and marginal models for correlated data.
- Applied generalized estimating equations (GEE) to model higher-order correlations.
Main Results:
- Familial association of neonatal mortality was strongest among siblings with adjacent birth orders.
- Birth-spacing effects on neonatal mortality were more pronounced when the preceding child survived the neonatal period.
- A first-order Markov model provided a good approximation for familial association.
Conclusions:
- Familial factors significantly influence neonatal mortality risk.
- Strategic birth spacing can mitigate neonatal mortality, especially following a surviving birth.
- Markov models with GEE offer a robust approach for analyzing familial aggregation in neonatal mortality.
Abstract:
This paper studies the familial association of neonatal mortality in Matlab, Bangladesh and its relationship to birth-spacing effects on mortality. Findings show that familial association is strongest for siblings of adjacent birth orders. Moreover, birth-spacing effects on neonatal mortality are stronger when the preceding child has survived the neonatal period than when it has died. Transitional (Markov), random-effects, and marginal models for correlated data are introduced, and are contrasted in interpretation and technique. Familial association of neonatal mortality can be approximately well by a first-order Markov model using generalized estimating equations (GEE) to allow for higher-order correlation.