title: The effect of mother's age and other related factors on neonatal survival associated with first and second birth in rural, Tanzania: evidence from Ifakara health and demographic surveillance system in rural Tanzania.
abstract: BACKGROUND
  With a view to improve neonatal survival, data on birth outcomes are critical for planning maternal and child health care services. We present information on neonatal survival from Ifakara Health and Demographic Surveillance System (HDSS) in Tanzania, regarding the influence of mother's age and other related factors on neonatal survival of first and second births.
  
  
  METHODS
  The study conducted analysis using longitudinal health and demographic data collected from Ifakara HDSS in parts of Kilombero and Ulanga districts in Morogoro region. The analysis included first and second live births that occurred within six years (2004-2009) and the unit of observation was a live birth. A logistic regression model was used to assess the influence of socio-demographic factors on neonates' survival.
  
  
  RESULTS
  A total of 18,139 first and second live births were analyzed. We found neonatal mortality rate of 32 per 1000 live births (95% CI: 29/1000-34/1000). Results from logistic regression model indicated increase in risk of neonatal mortality among neonates those born to young mothers aged 13-19 years compared with those whose mother's aged 20-34 years (aOR = 1.64, 95% CI = 1.34-2.02). We also found that neonates in second birth order were more likely to die than those in first birth order (aOR = 1.85: 95% CI = 1.52-2.26). The risk of neonatal mortality among offspring of women who had a partner co-resident was 18% times lower as compared with offspring of mothers without a partner co-resident in the household (aOR = 0.82: 95% CI = 0.66-0.98). Short birth interval (<33 months) was associated with increased risk of neonatal mortality (aOR = 1.50, 95% CI =1.16-1.96) compared with long birth interval (> = 33 months). Male born neonates were found to have an increased risk (aOR = 1.34, 95% CI =1.13- 1.58) of neonatal mortality as compared to their female counterparts.
  
  
  CONCLUSIONS
  Delaying the age at first birth may be a valuable strategy to promote and improve neonatal health and survival. Moreover, birth order, birth interval, mother's partner co-residence and sex of the neonate appeared as important markers for neonatal survival.
authors.affiliation: Ifakara Health Institute, (IHI), Plot 463, Kiko Avenue, off Old Bagamoyo Road, Mikocheni P,O Box 78373, Dar es Salaam, Tanzania. majiges@yahoo.com.
authors.forename: Majige
authors.initials: M
authors.lastname: Selemani
authors.forename: Mathew A
authors.initials: MA
authors.lastname: Mwanyangala
authors.forename: Sigilbert
authors.initials: S
authors.lastname: Mrema
authors.forename: Amri
authors.initials: A
authors.lastname: Shamte
authors.forename: Dan
authors.initials: D
authors.lastname: Kajungu
authors.forename: Abdallah
authors.initials: A
authors.lastname: Mkopi
authors.forename: Michael Johnson
authors.initials: MJ
authors.lastname: Mahande
authors.forename: Rose
authors.initials: R
authors.lastname: Nathan
mesh_terms: D000293:Adolescent; D000328:Adult; D001721:Birth Intervals; D001722:Birth Order; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D050498:Live Birth; D008137:Longitudinal Studies; D008297:Male; D008423:Maternal Age; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data*; D012737:Sex Factors; D013636:Tanzania / Q000453:epidemiology; D055815:Young Adult