A study of association between maternal tetanus toxoid immunization and neonatal mortality in the context of Bangladesh.

<h4>Background</h4>Maternal tetanus toxoid (MTT) vaccination during pregnancy remains an important factor for reducing infant mortality globally, especially in developing nations, including Bangladesh. Despite commendable progress in reducing child mortality through widespread MTT vaccin...

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Main Authors: Sujan Kumar Naha, Md Efty Islam Arpon, Rifa Tasfia Siddique, Farjana Rahman Ripa, Mohammad Nayeem Hasan, Md Jamal Uddin
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0316939
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author Sujan Kumar Naha
Md Efty Islam Arpon
Rifa Tasfia Siddique
Farjana Rahman Ripa
Mohammad Nayeem Hasan
Md Jamal Uddin
author_facet Sujan Kumar Naha
Md Efty Islam Arpon
Rifa Tasfia Siddique
Farjana Rahman Ripa
Mohammad Nayeem Hasan
Md Jamal Uddin
author_sort Sujan Kumar Naha
collection DOAJ
description <h4>Background</h4>Maternal tetanus toxoid (MTT) vaccination during pregnancy remains an important factor for reducing infant mortality globally, especially in developing nations, including Bangladesh. Despite commendable progress in reducing child mortality through widespread MTT vaccination during pregnancy, the issue still exists. This analysis explores the impact of MTT vaccination on neonatal mortality in Bangladesh and identifies associated factors.<h4>Methods</h4>This research utilizes data from the 2019 Bangladesh Multiple Indicator Cluster Survey (MICS). The dataset consists of 23,402 cases; among them, 587 cases resulted in infant death. The outcome variable was infant mortality, which was binary. The independent variables identified as potential contributors to the cause of death included tetanus toxoid vaccination status, mode of delivery (cesarean section or not), and mother's education level, among others. The Poisson model was employed to analyze the data.<h4>Results</h4>The analyses showed that the neonatal mortality rate was 2.51%. Notably, 45.90% of mothers received the MTT vaccination during pregnancy. Among them, 23.07% received a single dose, and 22.82% took adequate doses (receiving more than two doses) and adhered to WHO guidelines. The adjusted incidence rate ratio (IRR) was 1.36, which indicates that there was a 36% higher risk of neonatal mortality for those children whose mothers did not take TT (IRR = 1.36, p = 0.081). We also found that women from middle-class households (IRR = 1.58, 95% CI = 0.98, 2.54) and women with higher parity (IRR = 1.96, 95% CI = 0.95, 4.03) also had a higher risk of newborn fatalities. A comparable trend has been observed regarding the correlation between the number of tetanus doses administered and neonatal mortality, where it also emphasizes the importance of receiving adequate doses (a minimum of 2 doses of tetanus vaccine) to mitigate neonatal mortality (adjusted IRR = 0.54, 95% CI = 0.29, 1.01) in comparison to no doses received.<h4>Conclusion</h4>Administering a minimum of one maternal tetanus dose significantly lowers the risk of neonatal mortality. Other than Maternal Tetanus Toxoid vaccination, the analyses underscore various contributors to neonatal mortality, encompassing maternal healthcare, delivery procedures, socio-economic status, and education. Targeted interventions addressing these factors have the potential to efficiently decrease neonatal mortality rates and improve overall maternal and child health.
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spelling doaj-art-ec04e4740dc045609527d9a7c91c31fc2025-02-05T05:31:16ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01201e031693910.1371/journal.pone.0316939A study of association between maternal tetanus toxoid immunization and neonatal mortality in the context of Bangladesh.Sujan Kumar NahaMd Efty Islam ArponRifa Tasfia SiddiqueFarjana Rahman RipaMohammad Nayeem HasanMd Jamal Uddin<h4>Background</h4>Maternal tetanus toxoid (MTT) vaccination during pregnancy remains an important factor for reducing infant mortality globally, especially in developing nations, including Bangladesh. Despite commendable progress in reducing child mortality through widespread MTT vaccination during pregnancy, the issue still exists. This analysis explores the impact of MTT vaccination on neonatal mortality in Bangladesh and identifies associated factors.<h4>Methods</h4>This research utilizes data from the 2019 Bangladesh Multiple Indicator Cluster Survey (MICS). The dataset consists of 23,402 cases; among them, 587 cases resulted in infant death. The outcome variable was infant mortality, which was binary. The independent variables identified as potential contributors to the cause of death included tetanus toxoid vaccination status, mode of delivery (cesarean section or not), and mother's education level, among others. The Poisson model was employed to analyze the data.<h4>Results</h4>The analyses showed that the neonatal mortality rate was 2.51%. Notably, 45.90% of mothers received the MTT vaccination during pregnancy. Among them, 23.07% received a single dose, and 22.82% took adequate doses (receiving more than two doses) and adhered to WHO guidelines. The adjusted incidence rate ratio (IRR) was 1.36, which indicates that there was a 36% higher risk of neonatal mortality for those children whose mothers did not take TT (IRR = 1.36, p = 0.081). We also found that women from middle-class households (IRR = 1.58, 95% CI = 0.98, 2.54) and women with higher parity (IRR = 1.96, 95% CI = 0.95, 4.03) also had a higher risk of newborn fatalities. A comparable trend has been observed regarding the correlation between the number of tetanus doses administered and neonatal mortality, where it also emphasizes the importance of receiving adequate doses (a minimum of 2 doses of tetanus vaccine) to mitigate neonatal mortality (adjusted IRR = 0.54, 95% CI = 0.29, 1.01) in comparison to no doses received.<h4>Conclusion</h4>Administering a minimum of one maternal tetanus dose significantly lowers the risk of neonatal mortality. Other than Maternal Tetanus Toxoid vaccination, the analyses underscore various contributors to neonatal mortality, encompassing maternal healthcare, delivery procedures, socio-economic status, and education. Targeted interventions addressing these factors have the potential to efficiently decrease neonatal mortality rates and improve overall maternal and child health.https://doi.org/10.1371/journal.pone.0316939
spellingShingle Sujan Kumar Naha
Md Efty Islam Arpon
Rifa Tasfia Siddique
Farjana Rahman Ripa
Mohammad Nayeem Hasan
Md Jamal Uddin
A study of association between maternal tetanus toxoid immunization and neonatal mortality in the context of Bangladesh.
PLoS ONE
title A study of association between maternal tetanus toxoid immunization and neonatal mortality in the context of Bangladesh.
title_full A study of association between maternal tetanus toxoid immunization and neonatal mortality in the context of Bangladesh.
title_fullStr A study of association between maternal tetanus toxoid immunization and neonatal mortality in the context of Bangladesh.
title_full_unstemmed A study of association between maternal tetanus toxoid immunization and neonatal mortality in the context of Bangladesh.
title_short A study of association between maternal tetanus toxoid immunization and neonatal mortality in the context of Bangladesh.
title_sort study of association between maternal tetanus toxoid immunization and neonatal mortality in the context of bangladesh
url https://doi.org/10.1371/journal.pone.0316939
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