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Abstract：
OBJECTIVE: This study aimed to explore the effects of short birth spacing (SBS), which is defined as a period of less than 33 months between two successive births, on multiple concurrent forms of child malnutrition (MCFCM) and at least one form of child malnutrition (ALOFCM) using propensity score matching (PSM).
METHODS: This study used data extracted from the 2017-18 Bangladesh Demographic and Health Survey. PSM with four different distance functions, including logistic regression, classification and regression tree, single hidden layer neural network and random forest, were performed to evaluate the effects of SBS on MCFCM and ALOFCM. We also explored how the effects were modified in different subsamples, including women\'s empowerment, education and economic status (women\'s 3E index)-constructed based on women\'s decision-making autonomy, education level, and wealth index, and age at marriage, and place of residence.
RESULTS: The prevalence of SBS was 22.16% among the 4652 complete cases. The matched samples of size 2062 generated by PSM showed higher odds of MCFCM (adjusted OR (AOR)=1.25, 95% CI=1.02 to 1.56, p=0.038) and ALOFCM (AOR=1.20, 95% CI=1.01 to 1.42, p=0.045) for the SBS children compared with their counterparts. In the subsample of women with 3E index≥50% coverage, the SBS children showed higher odds of MCFCM (AOR: 1.43, 95% CI=1.03 to 2.00, p=0.041] and ALOFCM (AOR: 1.33, 95% CI=1.02 to 1.74, p=0.036). Higher odds of MCFCM (AOR=1.27, 95% CI=1.02 to 1.58, p=0.036) and ALOFCM (AOR=1.23, 95% CI=1.02 to 1.51, p=0.032) for SBS children than normal children were also evident for the subsample of mothers married at age≤18 years.
CONCLUSIONS: SBS was significantly associated with child malnutrition, and the effect was modified by factors such as women\'s autonomy and age at marriage.
METHODS: This study used data extracted from the 2017-18 Bangladesh Demographic and Health Survey. PSM with four different distance functions, including logistic regression, classification and regression tree, single hidden layer neural network and random forest, were performed to evaluate the effects of SBS on MCFCM and ALOFCM. We also explored how the effects were modified in different subsamples, including women\'s empowerment, education and economic status (women\'s 3E index)-constructed based on women\'s decision-making autonomy, education level, and wealth index, and age at marriage, and place of residence.
RESULTS: The prevalence of SBS was 22.16% among the 4652 complete cases. The matched samples of size 2062 generated by PSM showed higher odds of MCFCM (adjusted OR (AOR)=1.25, 95% CI=1.02 to 1.56, p=0.038) and ALOFCM (AOR=1.20, 95% CI=1.01 to 1.42, p=0.045) for the SBS children compared with their counterparts. In the subsample of women with 3E index≥50% coverage, the SBS children showed higher odds of MCFCM (AOR: 1.43, 95% CI=1.03 to 2.00, p=0.041] and ALOFCM (AOR: 1.33, 95% CI=1.02 to 1.74, p=0.036). Higher odds of MCFCM (AOR=1.27, 95% CI=1.02 to 1.58, p=0.036) and ALOFCM (AOR=1.23, 95% CI=1.02 to 1.51, p=0.032) for SBS children than normal children were also evident for the subsample of mothers married at age≤18 years.
CONCLUSIONS: SBS was significantly associated with child malnutrition, and the effect was modified by factors such as women\'s autonomy and age at marriage.
摘要：
目的：本研究旨在探讨短出生间隔（SBS）的影响，定义为连续两次分娩之间少于33个月的时间，使用倾向评分匹配（PSM）的多种并发形式的儿童营养不良（MCFCM）和至少一种形式的儿童营养不良（ALOFCM）。
方法：本研究使用了从2017-18年孟加拉国人口与健康调查中提取的数据。PSM具有四种不同的距离函数，包括逻辑回归，分类和回归树，单隐层神经网络和随机森林，进行了评价SBS对MCFCM和ALOFCM的影响。我们还探索了如何在不同的子样本中修改效果，包括赋予妇女权力，教育和经济地位(女性3E指数)--基于女性决策自主权构建，教育水平,财富指数，和结婚年龄，和居住地。
结果：在4652例完整病例中，SBS的患病率为22.16%。PSM产生的大小为2062的匹配样本显示，与SBS儿童相比，MCFCM（调整OR（AOR）=1.25，95％CI=1.02至1.56，p=0.038）和ALOFCM（AOR=1.20，95％CI=1.01至1.42，p=0.045）的几率更高。在3E指数覆盖率≥50%的女性子样本中，SBS患儿出现MCFCM(AOR:1.43,95%CI=1.03~2.00,p=0.041]和ALOFCM(AOR:1.33,95%CI=1.02~1.74,p=0.036)的几率较高.SBS儿童MCFCM（AOR=1.27，95％CI=1.02至1.58，p=0.036）和ALOFCM（AOR=1.23，95％CI=1.02至1.51，p=0.032）的几率高于正常儿童对于年龄≤18岁已婚母亲的子样本也很明显。
结论：SBS与儿童营养不良显著相关，这种影响受到女性自主权和结婚年龄等因素的影响。
方法：本研究使用了从2017-18年孟加拉国人口与健康调查中提取的数据。PSM具有四种不同的距离函数，包括逻辑回归，分类和回归树，单隐层神经网络和随机森林，进行了评价SBS对MCFCM和ALOFCM的影响。我们还探索了如何在不同的子样本中修改效果，包括赋予妇女权力，教育和经济地位(女性3E指数)--基于女性决策自主权构建，教育水平,财富指数，和结婚年龄，和居住地。
结果：在4652例完整病例中，SBS的患病率为22.16%。PSM产生的大小为2062的匹配样本显示，与SBS儿童相比，MCFCM（调整OR（AOR）=1.25，95％CI=1.02至1.56，p=0.038）和ALOFCM（AOR=1.20，95％CI=1.01至1.42，p=0.045）的几率更高。在3E指数覆盖率≥50%的女性子样本中，SBS患儿出现MCFCM(AOR:1.43,95%CI=1.03~2.00,p=0.041]和ALOFCM(AOR:1.33,95%CI=1.02~1.74,p=0.036)的几率较高.SBS儿童MCFCM（AOR=1.27，95％CI=1.02至1.58，p=0.036）和ALOFCM（AOR=1.23，95％CI=1.02至1.51，p=0.032）的几率高于正常儿童对于年龄≤18岁已婚母亲的子样本也很明显。
结论：SBS与儿童营养不良显著相关，这种影响受到女性自主权和结婚年龄等因素的影响。
