Maternal social characteristics and mortality from injuries among infants and toddlers in Estonia.

ABSTRACT

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.