Investigating the association causality of mortality in children under 5 due to abnormalities at birth based on social-ecological model in East Azarbaijan 2021-2022

Abstract

Introduction: Children's stunting history is often used as an indicator of the health and well-being of populations as well as the overall development of countries. If one of the important indicators of health and human development in the third millennium in the world is the rate of children under five years of age. Abnormalities at birth are one of the main causes of disability and death of children under five years of age and are considered as one of the main health problems of childhood. The present study was conducted to investigate the causes of stunting of children under five years of age due to abnormalities at birth with an ecological-social model in East Azarbaijan province in 2021-2022. Materials and methods: All children under 5 years of age who died (49 people) due to birth defects in East Azarbaijan province in northwest Iran in 2021-2022 were determined as the case group. For each case of in terms of child death, 4 living children were selected as controls (196) as a spatially and temporally matched sampling from Stockle’s social ecological model as a comprehensive and multi-faceted model to investigate the causes of children under five years of age. attrition.The causes of death of children under five years old were classified at the At the individual, social, enviromental and organizational level based on the information extracted from the death certificate of the file health and the data obtained from the interviow with the parent or caregiver of the child were used. Results: Finding univariate and multivariate logistic regression models were used to identify the causes of death of children under five years old due to birth defects.The chance of death of children whose weight was less (1-2kg) was equal to2.81[OR=2.81،95%CI(1.14-6.93)]. Their chance of dying was 24 times higher than that of healthy children[OR=24،95%CI(2.51-229.6)]. In families with a history of the death of other children, the chance of exthnction children was 9.79 times [OR=9.79,95%CI(3.17-30.24)]. The odds ratio of the child.The odds ratio of the child’s death 6.7 higher with the use of high-risk drugs by mothers during pregnancy [OR=6.7,95%CI(1.81-24.76)] the attenuation of children based on health literacy in the area of health behavior decision-making was significant (p=0.043). The odds ratio of attenuation of children with mothers with health literacy was equal to (0.77), that is, with increasing the health literacy of mothers showed a decrease of 23%. The chance of attenuation of children with regular vaccination was 0.07 times lower [OR=0.07,95%CI(0.02-0.23)]. The need to perform tests and ultrasound (p=0.001) was significant. Children whose mothers had ultrasound and regular tests during pregnancy had a lower odds ratio (0.21) times [OR=0.21,95%CI(0.57-0.80)]. The results of multivariate logistic regression for the death of children of under five years old due to birth abnormalities in an adjusted manner showed that the birth rate [OR=6.1,95%CI(2.23-17.82)] showed that birth rank was an individual factor and there was a history of birth abnormalities [OR=5.26,95%CI(1.80-15.43)] were most important social factors, regular vaccination of children [OR=0.72,95%CI(0.02-0.238)] and regular ultrasound and related tests [OR=0.21,95%CI(0.80-0.57] at the organizational level were identified as predictors of children’s attenuation. Conclusion: Higher birth rank and receiving high-risk drugs during pregnancy by mother as individual factors and, familial relationship and presence of history of birth abnormality in the family as social factors are the most important predictor of increased damping were children. Regular pregnancy care and regular vaccination of children were among the organizational factors that have a protective role against attenuation caused by abnormality. Increasing health literacy and empowering woman, performing genetic counseling, screening tests before marriage and during pregnancy, reduces the probability of abnormal children and their attenuation.

Key words: stunting of children under five years old, abnormalities at birth, health lit