How does mode of delivery associate with double burden of malnutrition among mother–child dyads?: A

Sutopa and Bari BMC Public Health (2022) 22:1243

https://doi.org/10.1186/s12889-022-13660-5

RESEARCH

How does mode of delivery associate

with double burden of malnutrition

among mother–child dyads?: a trend analysis

using Bangladesh demographic health surveys

Tasmiah Sad Sutopa* and Wasimul Bari

Abstract

Background: The simultaneity of undernourishment among child and overweight/obesity among mothers in lower￾and-middle-income-countries (LMICs) introduces a new nutrition dilemma, known as double burden of malnutrition

(DBM). Amidst of such paradox, the hike of caesarean section (CS) delivery is also triggering child undernutrition and

maternal obesity. A gap of knowledge regarding the efect of mode of delivery on DBM still persists. The study aims to

explore the association between DBM at household level and mode of delivery over time in LMICs.

Method: The study used data from recent four consecutive waves of Bangladesh Demographic and Health Survey

(BDHS) ranging from BDHS 2007 to BDHS 2017. It considered the mother–child pairs from data where mothers were

non-pregnant women aged 15–49 years having children born in last 3 years preceding the survey. Bivariate analysis

and Logistic Regression were performed to explore the unadjusted and adjusted efect of covariates on DBM. An

interaction term of mode of delivery and survey year was considered in regression model.

Results: The study evinces a sharp increase of DBM rate in Bangladesh from 2007 to 2017 (2.4% vs. 6.4%). The preva￾lence of DBM in household level among the children delivered by CS is more than two times of those born by normal

delivery (8.2% vs. 3.5%). The multivariate analysis also indicates that the children born by CS delivery are more likely to

be afected by DBM at household level signifcantly than those born by normal delivery in each waves. Moreover, the

odds ratio (OR) of DBM at household is increased by 43% for one unit change in time for normal delivery whereas CS

delivery births have 12% higher odds of DBM at household level with one unit change in time.

Conclusion: The study discloses a drastic increase of rate of DBM among mother–child pairs over the time. It stipu￾lates infated risk of DBM at household with time for both mode of delivery but the children with CS delivery are at

more risk to the vulnerability of DBM at household level. The study recommends a provision of special care to the

mothers with CS delivery to reduce DBM at household.

Keywords: Double burden of malnutrition, Mode of delivery, Caesarean, Bangladesh, Trend

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Introduction

Lower-and-middle-income-countries (LMICs) have

been going through a nutrition transition due to rapid

economic growth and technological advancement [1].

Tough LMICs have a long history of acute malnutri￾tion among children because of food insecurity, disease

Open Access

*Correspondence: [email protected]

Department of Statistics, University of Dhaka, Dhaka, Bangladesh