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The association between household socio-economic status, maternal socio-demographic characteristics and adverse birth and infant growth outcomes in sub-Saharan Africa: a systematic review

Published online by Cambridge University Press:  25 October 2019

Christian Bwangandu Ngandu Open the ORCID record for Christian Bwangandu Ngandu [Opens in a new window] ,
Douglas Momberg Open the ORCID record for Douglas Momberg [Opens in a new window] ,
Ansuyah Magan ,
Lumbwe Chola ,
Shane A. Norris  and
Rihlat Said-Mohamed
Christian Bwangandu Ngandu*
Affiliation:
MRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa
Douglas Momberg
Affiliation:
MRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa
Ansuyah Magan
Affiliation:
School of public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Lumbwe Chola
Affiliation:
School of public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Shane A. Norris
Affiliation:
MRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa DST-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
Rihlat Said-Mohamed
Affiliation:
MRC/WITS Developmental Pathways for Health Research Unit, Department of Paediatrics and Child Health, University of the Witwatersrand, Johannesburg, South Africa DST-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa DST-NRF Centre of Excellence in Food Security, University of the Western Cape, Cape Town, South Africa
*
Address for correspondence: Bwangandu Ngandu, SAMRC/WITS Developmental Pathways for Health Research Unit, Johannesburg, Gauteng, South Africa. Email: 1297539@students.wits.ac.za
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Abstract

Adverse birth outcomes and infant undernutrition remain the leading causes of morbidity and mortality in sub-Saharan Africa (SSA). Impaired infant growth and development, which often begins during foetal development, may persist during the first 2 years of life and has been associated with higher risks of cardiometabolic diseases. This systematic review assessed the associations between maternal demographic characteristics and household socio-economic status (SES), and preterm birth (PTB), small for gestational age, low birth weight (LBW), stunting, wasting and underweight in children under 2 years of age in SSA countries. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, we searched for publications in three electronic databases (PubMed, Scopus and ScienceDirect). Eleven studies on children under 2 years of age, in four SSA regions, published in English between 1990 and 2018, were included. All the studies were observational in design (cross-sectional or cohort studies). Maternal education was the most commonly explored exposure. Most studies (63.3%) focused on undernutrition during the first 2 years of life: LBW, PTB and stunting. Lower maternal education, maternal unemployment and lower household wealth index were the SES factors most commonly associated with adverse birth outcomes and infant undernutrition. Maternal marital status was not associated with any infant outcomes. The definitions of the SES varied, which may explain discrepancies between studies. Nutrition intervention programs in SSA need to promote education and poverty alleviation in women at reproductive age, starting from pre-pregnancy, to optimise infant growth and development and prevent the increase in the prevalence of cardiometabolic diseases.

Keywords

Socio-economic factorsinfant undernutritionsub-Saharan Africa
Type
Review
Information
Journal of Developmental Origins of Health and Disease , Volume 11 , Issue 4 , August 2020 , pp. 317 - 334
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2019

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