Maternal social characteristics and mortality from injuries among infants and toddlers in Estonia.
BACKGROUND
Injuries are a major cause of ill health among children, with a social gradient in child injuries documented in many countries. The effects of maternal sociodemographic characteristics on injury mortality in Estonian infants and toddlers were investigated.


METHODS
A population-based study using linkage of data from the Estonian Medical Birth Registry with Mortality Database. A total of 148 521 children born 1992-2002 were followed for injury mortality (ICD-9 E800-E999) from birth to third birthday. Associations of maternal age, education, marital status, nationality, place of residence and child's birth order and multiplicity with risk of injury death were studied using logistic regression.


RESULTS
Maternal age (<20 years compared with > or =30 years: OR 2.12; 95% CI 1.00 to 4.51), education (basic compared with secondary or higher: OR 3.22; 95% CI 2.12 to 4.87), marital status (single, divorced or widowed compared with married: OR 2.74; 95% CI 1.53 to 4.91), nationality (other compared with Estonian: OR 2.00; 95% CI 1.32 to 3.02), birth order (fourth or higher compared with first: OR 6.66; 95% CI 3.42 to 12.99), and multiple birth (twin or triplet compared with singleton: OR 3.12; 95% CI 1.44 to 6.73) affected the risk of injury death among infants (<1 year). Among toddlers (1-2 years), boys were at higher risk than girls (OR 1.75; 95% CI 1.15 to 2.66) and low mother's education (basic compared with secondary or higher OR 2.08; 95% CI 1.28 to 3.37) and high birth order (fourth or higher compared with first: OR 7.88; 95% CI 3.90 to 15.90) increased the risk of injury death.


CONCLUSIONS
Maternal sociodemographic characteristics are associated with injury mortality among infants and toddlers. Substantial variation in injury mortality rates within Estonia suggests potential for prevention.
Tiikkaja
S
S
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, SE-171 77 Stockholm, Sweden. Sanna.Tiikkaja@ki.se
Rahu
K
K
Koupil
I
I
Rahu
M
M
D000328:Adult; D001722:Birth Order; D002423:Cause of Death; D002675:Child, Preschool; D004522:Educational Status; D004812:Epidemiologic Methods; D004957:Estonia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017533:Marital Status; D008423:Maternal Age; D009035:Mothers; D012424:Rural Population; D012737:Sex Factors; D014947:Wounds and Injuries / Q000453:epidemiology / Q000401:mortality*; D055815:Young Adult