Effects of Birth Month on Child Health and Survival in Sub-Saharan Africa

Abstract

Birth month is broadly predictive of both under-five mortality rates and stunting throughout most of sub-Saharan Africa (SSA). Observed factors, such as mother's age at birth and educational status, are correlated with birth month but are not the main factors underlying the relationship between birth month and child health. Accounting for maternal selection via a fixed-effects model attenuates the relationship between birth month and health in many SSA countries. In the remaining countries, the effect of birth month may be mediated by environmental factors. Birth month effects on mortality typically do not vary across age intervals; the differential mortality rates by birth month were evident in the neonatal period and continued across age intervals. The male-to-female sex-ratio at birth did not vary by birth month, which suggests that in utero exposures are not influencing fetal loss, and therefore, the birth month effects are not likely due to selective survival during the in utero period. In one-third of the sample, the birth month effects on stunting diminished after the age of two years; therefore, some children were able to catch-up. Policies to improve child health should target pregnant women and infants and must take seasonality into account.

Factors affecting energetic regulation of ovulation leading to birth seasonality in tropical and temperate subpopulations

“…Supporting this, Dorélien (2015) refers to mortality among young adults in the Gambia, which was found to be increased in those born in the hunger season (Moore et al 1997), and her own research investigating child mortality in sub-Saharan Africa according to birth month.…”

The Effects of In Utero Exposure to Influenza on Birth and Infant Outcomes in the US

“…(1) maternal selection (in that women of different backgrounds do not give birth at the same rates across the year); and (2) the fact that different conception months are associated with different exposures to seasonallyvarying determinants of health (Dorélien 2015).…”

“…Furthermore, because they use historical data, these studies have most often looked at long-term effects rather than health at birth and other early life outcomes. For its part, birth month, which can be taken as a proxy for seasonal shocks, has been found to be an important predictor of health and other outcomes (Moore et al 1997;Doblhammer and Vaupel 2001;Gluckman et al 2008;Huber et al 2004;Torrey et al 1997;Dorélien 2015). The literature on seasonality in birth and infant outcomes in developed countries has primarily focused on and prioritized the role of ambient temperature and air pollution, and to a lesser extent has focused on the role of the disease environment.…”

“…; Torrey et al. ; Dorélien ). The literature on seasonality in birth and infant outcomes in developed countries has primarily focused on and prioritized the role of ambient temperature and air pollution, and to a lesser extent has focused on the role of the disease environment.…”

“…In the US and other countries in which high‐quality data on gestational ages and birth date records are available, we can group the remaining possible explanations for seasonality in health at birth into two categories: (1) maternal selection (in that women of different backgrounds do not give birth at the same rates across the year); and (2) the fact that different conception months are associated with different exposures to seasonally‐varying determinants of health (Dorélien ).…”