Birth Order and Nutritional Disparities: A Cross-Sectional Study Among Hospitalized Siblings in Umerkot, Pakistan
Birth Order and Nutrition in Hospitalized Children
Keywords:
Birth order, Malnutrition, Pediatric nutrition, MUAC, Hospitalized children, PakistanAbstract
ABSTRACT
Background
Malnutrition remains a leading cause of morbidity and mortality in children under five years, particularly in resource-limited settings. While multiple factors influence nutritional status, intra-household dynamics, including birth order, are often overlooked. This study investigates the relationship between birth order and nutritional status among hospitalized children in Umerkot, Pakistan.
Methods
This cross-sectional study analyzed data from 298 pediatric inpatients aged 6–59 months admitted to the District Headquarter Hospital in Umerkot. Anthropometric assessments were conducted using WHO criteria, with mid-upper arm circumference (MUAC) as the primary nutritional indicator. Data on birth order, immunization, feeding patterns, and clinical diagnosis were collected through structured caregiver interviews. Chi-square tests, logistic regression, and multivariate analyses were used to examine associations.
Results
Malnutrition was present in 34.6% of children. A significant association was found between higher birth order (third child or later) and increased risk of malnutrition (p<0.01). Children of second or third birth order had higher odds of moderate to severe malnutrition compared to first-borns (OR: 2.31; 95% CI: 1.38–3.87). Confounding variables such as age, residence, and immunization status were adjusted using logistic regression.
Conclusions
Birth order is a significant determinant of nutritional status among hospitalized children. Health interventions must consider intra-household equity, targeting higher-order siblings with focused nutritional support, caregiver education, and family planning services to break the intergenerational cycle of malnutrition.
Keywords
Birth order; Malnutrition; Pediatric nutrition; MUAC; Hospitalized children; Pakistan
References
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