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The Effect of Maternal Death on the Health of the Husband and Children in a Rural Area of China: A Prospective Cohort Study

Thursday, 23rd of June 2016

“The index children who experienced the loss of a mother had a significantly higher likelihood of dying, abandonment and malnutrition.”

PLoS One. 2016 Jun 9;11(6):e0157122. doi: 10.1371/journal.pone.0157122. eCollection 2016.

The Effect of Maternal Death on the Health of the Husband and Children in a Rural Area of China: A Prospective Cohort Study

Zhou H1, Zhang L2, Ye F3, Wang HJ4, Huntington D5, Huang Y6, Wang A1, Liu S1, Wang Y1.

Author information

1Division of Maternal and Child Health, School of Public Health, Peking University, No.38 Xueyuan Road Haidian District, Beijing, China.

2Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.

3Department of Preventive Health Care, China-Japan Friendship Hospital, Beijing, China No.38 Xueyuan Road Haidian District, Beijing, China.

4Institute of Child and Adolescent Health, School of Public Health, Peking University, No.38 Xueyuan Road Haidian District, Beijing, China.

5Asia Pacific Observatory on Health Systems and Policies, World Health Organization Western Pacific Regional Office, Manila, Philippines.

6Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.

Abstract

OBJECTIVE:

To examine the effects of maternal death on the health of the index child, the health and educational attainment of the older children, and the mental health and quality of life of the surviving husband.

METHODS:

A cohort study including 183 households that experienced a maternal death matched to 346 households that experienced childbirth but not a maternal death was conducted prospectively between June 2009 and October 2011 in rural China. Data on household sociodemographic characteristics, physical and mental health were collected using a quantitative questionnaire and medical examination at baseline and follow-up surveys. Multivariate linear regression, logistic regression models and difference-in-difference (DID) were used to compare differences of outcomes between two groups.

FINDINGS:

The index children who experienced the loss of a mother had a significantly higher likelihood of dying, abandonment and malnutrition compared to children whose mothers survived at the follow-up survey. The risk of not attending school on time and dropping out of school among older children in the affected group was higher than those in the control group during the follow-up. Husbands whose wife died had significantly lower EQ-5D index and EQ-VAS both at baseline and at follow-up surveys compared to those without experiencing a wifes death, suggesting an immediate and sustained poorer mental health quality of life among the surviving husbands. Also the prevalence of posttraumatic stress disorder (PTSD) was 72.6% at baseline and 56.2% at follow-up among husbands whose wife died.

CONCLUSIONS:

Maternal death has multifaceted and spillover effects on the physical and mental health of family members that are sustained over time. Programmes that reduce maternal mortality will mitigate repercussions on surviving family members are critical and needed.

Economic impact of maternal death on households in rural china: a prospective cohort study.[PLoS One. 2013]

Economic impact of maternal death on households in rural china: a prospective cohort study.

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The Effect of Maternal Death on the Health of the Husband and Children in a Rura...

The Effect of Maternal Death on the Health of the Husband and Children in a Rural Area of China: A Prospective Cohort Study.

PLoS One. 2016 Jun 9 ;11(6):e0157122. doi: 10.1371/journal.pone.0157122. eCollection 2016.