International Journal of Epidemiology, Volume 33, Number 1, pp. 130-136
IJE vol.33 no.1 © International Epidemiological Association 2004; all rights reserved.
Special Theme: Perinatal and early-life influences on disease |
Season of birth is not associated with risk of early adult death in rural Senegal
1 UR 24 (Epidemiology and Prevention Unit), Institut de Recherche pour le Développement (IRD, formerly named ORSTOM), BP 64501, 34394 Montpellier Cedex 5, France
2 US 009 (Niakhar Population and Health Unit), IRD, BP 1386, Dakar, Senegal
3 Bandim Health Project, Danish Epidemiology Science Centre, Bissau, Guinea-Bissau
Correspondence: KB Simondon, Centre IRD, BP 64501, 34394 Montpellier Cedex 5, France. E-mail: kirsten.simondon{at}mpl.ird.fr
Background In a rural area of the Gambia, West Africa, young adults born in the ‘hungry’ season had a high excess of deaths (mortality ratios (MR): 3.7 from 14.5 years and 10.3 from 25 years, P < 0.0001). Among several potential causal factors, fetal undernutrition was considered the most plausible. This study is a similar analysis of children and young adults living in rural Senegal, close to the Gambia.
Methods A cohort of 9192 subjects born 1962–2001 with prospectively collected dates of birth and death was analysed. MR by season of birth (July–December/January–June) was estimated using Cox's proportional hazards analysis. The nutritional status of non-pregnant women was analysed at monthly intervals 1990–1996.
Results MR by season of birth was slightly greater than 1 during infancy, and close to 1 from 1–5 years and from 5–14.5 years. From 14.5 years old the MR was 0.77 (95% CI: 0.47, 1.25, P = 0.29), compared with 0.53 (95% CI: 0.28, 1.02, P = 0.056) from 20 years and 0.33 (95% CI: 0.09, 1.25, P = 0.10) from 25 years. The weight of women varied strongly by season: means were 3.0–3.9 kg lower at the end of the rainy season (September–November) than during the dry season (February–May, P < 0.001 for each year).
Conclusions This study found no increased risk of death among young adults born during the hungry season in a rural West African area despite large seasonal variations in women's nutritional status. The strongly increased risk in adult Gambians is probably not explained by fetal undernutrition.
Keywords Mortality, seasons, fetal growth retardation, Africa, nutrition disorders, cohort studies
Accepted 26 June 2003
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