Maternal anemia and baby birth size mediate the association between short birth interval and under-five undernutrition in Ethiopia: a generalized structural equation modeling approach
Abstract Background Studies assessing the association between short birth interval, a birth-to-birth interval of less than 33 months, and under-five undernutrition have produced inconclusive results. This study aimed to assess the relationship between short birth interval and outcomes of stunting, u...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-02-01
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| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12887-022-03169-6 |
| _version_ | 1818914160411410432 |
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| author | Desalegn Markos Shifti Catherine Chojenta Elizabeth G. Holliday Deborah Loxton |
| author_facet | Desalegn Markos Shifti Catherine Chojenta Elizabeth G. Holliday Deborah Loxton |
| author_sort | Desalegn Markos Shifti |
| collection | DOAJ |
| description | Abstract Background Studies assessing the association between short birth interval, a birth-to-birth interval of less than 33 months, and under-five undernutrition have produced inconclusive results. This study aimed to assess the relationship between short birth interval and outcomes of stunting, underweight, and wasting among children aged under-five in Ethiopia, and potential mediation of any associations by maternal anemia and baby birth size. Method Data from the 2016 Ethiopia Demographic and Health Survey (EDHS) was used. Stunting, wasting, and underweight among children aged under-five were outcome variables. Generalized Structural Equation Modeling (GSEM) was used to examine associations between short birth interval and outcomes, and to assess hypothesized mediation by maternal anemia and baby birth size. Results Significant associations between short birth interval and stunting (AOR = 1.49; 95% CI = 1.35, 1.66) and underweight (AOR = 1.43; 95% CI = 1.28, 1.61) were found. There was no observed association between short birth interval and wasting (AOR = 1.05; 95% CI = 0.90, 1.23). Maternal anemia and baby birth size had a significant partial mediation effect on the association between short birth interval and stunting (the coefficient reduced from β = 0.337, p < 0.001 to β = 0.286, p < 0.001) and underweight (the coefficient reduced from β = 0.449, p < 0.001 to β = 0.338, p < 0.001). Maternal anemia and baby birth size mediated 4.2% and 4.6% of the total effect of short birth interval on stunting and underweight, respectively. Conclusion Maternal anemia and baby birth size were identified as mediators of the association between short birth interval and under-five undernutrition status. Policies and programs targeting the reduction of under-five undernutrition should integrate strategies to reduce maternal anemia and small baby birth size in addition to short birth interval. |
| first_indexed | 2024-12-19T23:41:58Z |
| format | Article |
| id | doaj.art-bf416b4864004211b5e356991c42da82 |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-12-19T23:41:58Z |
| publishDate | 2022-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-bf416b4864004211b5e356991c42da822022-12-21T20:01:23ZengBMCBMC Pediatrics1471-24312022-02-0122111110.1186/s12887-022-03169-6Maternal anemia and baby birth size mediate the association between short birth interval and under-five undernutrition in Ethiopia: a generalized structural equation modeling approachDesalegn Markos Shifti0Catherine Chojenta1Elizabeth G. Holliday2Deborah Loxton3Saint Paul’s Hospital Millennium Medical CollegeCentre for Women’s Health Research, School of Medicine and Public Health, University of NewcastleCentre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of NewcastleCentre for Women’s Health Research, School of Medicine and Public Health, University of NewcastleAbstract Background Studies assessing the association between short birth interval, a birth-to-birth interval of less than 33 months, and under-five undernutrition have produced inconclusive results. This study aimed to assess the relationship between short birth interval and outcomes of stunting, underweight, and wasting among children aged under-five in Ethiopia, and potential mediation of any associations by maternal anemia and baby birth size. Method Data from the 2016 Ethiopia Demographic and Health Survey (EDHS) was used. Stunting, wasting, and underweight among children aged under-five were outcome variables. Generalized Structural Equation Modeling (GSEM) was used to examine associations between short birth interval and outcomes, and to assess hypothesized mediation by maternal anemia and baby birth size. Results Significant associations between short birth interval and stunting (AOR = 1.49; 95% CI = 1.35, 1.66) and underweight (AOR = 1.43; 95% CI = 1.28, 1.61) were found. There was no observed association between short birth interval and wasting (AOR = 1.05; 95% CI = 0.90, 1.23). Maternal anemia and baby birth size had a significant partial mediation effect on the association between short birth interval and stunting (the coefficient reduced from β = 0.337, p < 0.001 to β = 0.286, p < 0.001) and underweight (the coefficient reduced from β = 0.449, p < 0.001 to β = 0.338, p < 0.001). Maternal anemia and baby birth size mediated 4.2% and 4.6% of the total effect of short birth interval on stunting and underweight, respectively. Conclusion Maternal anemia and baby birth size were identified as mediators of the association between short birth interval and under-five undernutrition status. Policies and programs targeting the reduction of under-five undernutrition should integrate strategies to reduce maternal anemia and small baby birth size in addition to short birth interval.https://doi.org/10.1186/s12887-022-03169-6Short birth intervalAnemiaBaby birth sizeStuntingWastingUnderweight |
| spellingShingle | Desalegn Markos Shifti Catherine Chojenta Elizabeth G. Holliday Deborah Loxton Maternal anemia and baby birth size mediate the association between short birth interval and under-five undernutrition in Ethiopia: a generalized structural equation modeling approach BMC Pediatrics Short birth interval Anemia Baby birth size Stunting Wasting Underweight |
| title | Maternal anemia and baby birth size mediate the association between short birth interval and under-five undernutrition in Ethiopia: a generalized structural equation modeling approach |
| title_full | Maternal anemia and baby birth size mediate the association between short birth interval and under-five undernutrition in Ethiopia: a generalized structural equation modeling approach |
| title_fullStr | Maternal anemia and baby birth size mediate the association between short birth interval and under-five undernutrition in Ethiopia: a generalized structural equation modeling approach |
| title_full_unstemmed | Maternal anemia and baby birth size mediate the association between short birth interval and under-five undernutrition in Ethiopia: a generalized structural equation modeling approach |
| title_short | Maternal anemia and baby birth size mediate the association between short birth interval and under-five undernutrition in Ethiopia: a generalized structural equation modeling approach |
| title_sort | maternal anemia and baby birth size mediate the association between short birth interval and under five undernutrition in ethiopia a generalized structural equation modeling approach |
| topic | Short birth interval Anemia Baby birth size Stunting Wasting Underweight |
| url | https://doi.org/10.1186/s12887-022-03169-6 |
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