Risk of childhood mortality associated with death of a mother in low-and-middle-income countries: a systematic review and meta-analysis

Nguyen, Diep Thi Ngoc; Hughes, Suzanne; Egger, Sam; LaMontagne, D. Scott; Simms, Kate; Castle, Phillip E.; Canfell, Karen

doi:10.1186/s12889-019-7316-x

Table 3 Risk estimates for childhood mortality, stratified by exposure and outcome

From: Risk of childhood mortality associated with death of a mother in low-and-middle-income countries: a systematic review and meta-analysis

a.) Pooled risk of child mortality stratified by death of a mother when child aged 0–42 days, 0–12 months, 0–5 years and 0–10 years
Age of child at mother’s death (exposure)	Age at risk of child death (outcome)
	0–7 days	8–28 days	0–28 days	1–6 months	6–12 months	0–1 years	1–2 years	2–3 years	3–4 years	4–5 years	5–10	0–10	0–12 years	0–18 years
0–42 days^a	4.03 (2.92–5.57)^a	11.73 (3.82–36.01)	11.31 (5.88–21.75)^b	35.48 (9.65–130.47)^c	2.81 (0.74–10.73)		6.86 (2.19–21.45)						3.96 (2.17–7.22)	1.39 (0.37–5.21)
0–12 months^m			11.06 (3.74–32.74)^d	27.45 (17.61–42.81)^e	12.20 (7.91–18.81)^f	15.90 (2.1–16.10)^g	9.79 (5.66–16.91)	1.66 (0.2–11.86)	3.79 (0.54–26.72)
0–5 yearsⁿ													4.12 (2.96–5.74)^h
0–10 years^o		6.99 (2.98–16.38)		11.92 (2.15–65.96)ⁱ	5.08 (0.32–79.80)^j		5.94 (2.72–12.97)^k	2.85 (1.30–6.02)	2.53 (1.05–6.11)	5.09 (2.52–10.28)	2.13 (1.11–4.08)	4.66 (3.1–4.89)		3.67 (2.01–6.73)
b) Relative risk of childhood mortality stratified by mother’s death at multiple discrete sequential intervals of child age
Included articles			Number of studies, n exposed/unexposed deaths			Age of child at mother’s death (exposure)			Age of child at child death			Risk estimate (95% CI) (Outcome)
Masmas, et al., 2004 (rural and urban cohorts) [27]			2 cohorts, 26/34 child deaths			0–42 days			Birth up to 18 years			2.79 (1.06–7.34), meta-analysis, p [het] = 0.28^p
			1 cohort, 10/12 child deaths			42 days- < 6 months			6 weeks-12 years			5.61 (2.07–15.21)
			2 cohorts from one study, 7/7 child deaths			6–11 months			6 months up to18 years			5.58 (1.58–19.70), meta-analysis, p [het] = 0.78)^p
			2 studies (3 cohorts), 9 child deaths			1- < 2 years			1 year up to 18 years			5.18 (1.16–23.26), meta-analysis, p [het] = 0.20)^p
			2 cohorts from one study, 9 child deaths			≥2 years			2 years up to18 years			1.88 (0.75–4.69), meta-analysis, p [het] = 0.78)^p
Sartorius et al., 2010 and 2011 [24, 25]			1 cohort, 91child deaths (30% of mother died of HIV/TB)			0–1 year			0–1 year			51.11 (8.49–200.80)
			1 cohort, 191 child deaths (not due to HIV/TB)			1–4 years			1–4 years			5.17 ((2.84–8.29)
c) Risks of child mortality by time since mother’s death
			Number of studies, n exposed/n unexposed deaths			Time since mother’s death (exposure)			Age at risk of child’s death			Relative risk of child death, 95%CI
Clark et al., 2013 [11]			1 estimate, 193/1,537,831 observed child-months			0 month			0–59 months			12.55 (6.22–25.34)
Clark et al., 2013 [11]			1 estimate, 295/1,537,831observed child-months			1–2 months			0–59 months			7.01 (3.16–15.56)
Clark et al., 2013 [11]			1 estimate, 740/1,537,831observed child-months			3–5 months			0–59 months			4.03 (1.53–10.58)
Masmas, et al., 2004 (rural and urban cohorts) [27]			2 estimates, 46/74 child deaths			0–5 months ago			0 up to 18 years			4.72 (2.56–8.72), meta-analysis, p [het] = 0.22^q
Masmas, et al., 2004 (rural and urban cohorts) and Clark et al., 2013 [11, 27]			3 estimates, 18/74 child deaths			> 6 months ago			0 up to 18 years			2.08 (1.27–3.41), meta-analysis, p [het] = 0.69^q

Pooled estimates: ^apooled estimate based on three studies, exposed deaths:46; ^bpooled estimate from four studies, exposed deaths = 114; ^cpooled estimate from two studies, exposed deaths = 25; ^dpooled estimate from two studies, exposed deaths = 35; ^epooled estimate from three studies, exposed deaths = 56; ^fpooled estimate from two studies, exposed deaths = 24; ^gpooled estimate from two studies, exposed deaths = NR (Ng’weshemi et al. [33] did not reported number of child deaths for 0–1 year); ^hpooled estimate from two studies, exposed deaths = 124; ⁱpooled estimate from two studies, exposed deaths = 57; ^j pooled estimate from two studies, exposed deaths = 22; ^kpooled estimate from two studies, exposed deaths = 26; remaining estimates were from one study only; ^lsee Fig. 1; ^msee Fig. 2; ⁿsee Fig. 3; ^osee Fig. 4; ^psee Additional file 3: Figure S7A; ^qsee Additional file 3: Figure S7B;

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ISSN: 1471-2458

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