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Increased mortality risk for motherless children aged less than 5 years: a systematic review and meta-analysis

Increased mortality risk for motherless children aged less than 5 years: a systematic review and meta-analysis
Increased mortality risk for motherless children aged less than 5 years: a systematic review and meta-analysis
Background: It is unclear whether the association between maternal and infant survival seen in the context of HIV applies to the general population.
Objective: To investigate the relationship between maternal survival and mortality of children <5 years outside the HIV context.

Methods: A systematic review of literature published between January 1990 and November 2016 (3079 papers identified, 156 abstracts screened, 23 full texts) reporting mother’s vital status and mortality of children less than five years of age. Eight studies were included in a qualitative analysis and four in a meta-analysis using a random effects model. Summary estimates of the odds of dying by maternal survival were obtained and statistical heterogeneity estimated. Quality of included studies was assessed using the ROBINS –I Tool and quality of the body evidence was assessed using GRADE.

Findings: Children < 5 years whose mother had died were 4.09 times (95% confidence interval, CI: 2.40, 6.98) more likely to die than those of surviving mothers (I2= 83%). Due to heterogeneity, further pooled estimates were not possible. The odds of dying ranged from 1.40 (95% CI 0.47,4.21) to 2.92 (95% CI 1.21,7.04) in two-four year olds, 6.1 (95% CI 2.27,16.77) to 33.78 (95% CI 24.21,47.14) in infants <one year and 4.39 (95% CI 3.34, 5.78 ) to 52.46 (95% CI 20.48,131.79) in infants <six months.

Conclusion: The loss of a mother was associated with increased mortality among children, especially when maternal death occurred in the first year post delivery.
0042-9686
1-35
Chikhungu, Lana
fee4094c-4df0-41d9-bfae-947f32519a11
Newell, Marie-Louise
c6ff99dd-c23b-4fef-a846-a221fe2522b3
Rollins, Nigel
79b9cfdb-4a6b-44c1-89d9-dbe948a09167
Chikhungu, Lana
fee4094c-4df0-41d9-bfae-947f32519a11
Newell, Marie-Louise
c6ff99dd-c23b-4fef-a846-a221fe2522b3
Rollins, Nigel
79b9cfdb-4a6b-44c1-89d9-dbe948a09167

Chikhungu, Lana, Newell, Marie-Louise and Rollins, Nigel (2016) Increased mortality risk for motherless children aged less than 5 years: a systematic review and meta-analysis. Bulletin of the World Health Organization, 1-35. (In Press)

Record type: Article

Abstract

Background: It is unclear whether the association between maternal and infant survival seen in the context of HIV applies to the general population.
Objective: To investigate the relationship between maternal survival and mortality of children <5 years outside the HIV context.

Methods: A systematic review of literature published between January 1990 and November 2016 (3079 papers identified, 156 abstracts screened, 23 full texts) reporting mother’s vital status and mortality of children less than five years of age. Eight studies were included in a qualitative analysis and four in a meta-analysis using a random effects model. Summary estimates of the odds of dying by maternal survival were obtained and statistical heterogeneity estimated. Quality of included studies was assessed using the ROBINS –I Tool and quality of the body evidence was assessed using GRADE.

Findings: Children < 5 years whose mother had died were 4.09 times (95% confidence interval, CI: 2.40, 6.98) more likely to die than those of surviving mothers (I2= 83%). Due to heterogeneity, further pooled estimates were not possible. The odds of dying ranged from 1.40 (95% CI 0.47,4.21) to 2.92 (95% CI 1.21,7.04) in two-four year olds, 6.1 (95% CI 2.27,16.77) to 33.78 (95% CI 24.21,47.14) in infants <one year and 4.39 (95% CI 3.34, 5.78 ) to 52.46 (95% CI 20.48,131.79) in infants <six months.

Conclusion: The loss of a mother was associated with increased mortality among children, especially when maternal death occurred in the first year post delivery.

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Accepted/In Press date: 13 December 2016
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 403878
URI: http://eprints.soton.ac.uk/id/eprint/403878
ISSN: 0042-9686
PURE UUID: d73b4bf1-aa4e-4995-b48e-3f3b32c8b93f
ORCID for Marie-Louise Newell: ORCID iD orcid.org/0000-0002-1074-7699

Catalogue record

Date deposited: 14 Dec 2016 13:38
Last modified: 18 Feb 2021 17:22

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Contributors

Author: Lana Chikhungu
Author: Nigel Rollins

University divisions

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