Maternal preconceptional and prenatal exposure to El Niño Southern Oscillation levels and child mortality: a multi-country study

Hongbing Xu, Castiel Chen Zhuang (), Vanessa M. Oddo, Espoir Bwenge Malembaka, Xinghou He, Qinghong Zhang and Wei Huang
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Hongbing Xu: Peking University School of Public Health
Castiel Chen Zhuang: Peking University School of Economics
Vanessa M. Oddo: University of Illinois Chicago
Espoir Bwenge Malembaka: Université Catholique de Bukavu
Xinghou He: Peking University School of Public Health
Qinghong Zhang: Peking University
Wei Huang: Peking University School of Public Health

Nature Communications, 2024, vol. 15, issue 1, 1-15

Abstract: Abstract El Niño Southern Oscillation (ENSO) has been shown to relate to the epidemiology of childhood infectious diseases, but evidence for whether they increase child deaths is limited. Here, we investigate the impact of mothers’ ENSO exposure during and prior to delivery on child mortality by constructing a retrospective cohort study in 38 low- and middle-income countries. We find that high levels of ENSO indices cumulated over 0–12 lagged months before delivery are associated with significant increases in risks of under-five mortality; with the hazard ratio ranging from 1.33 (95% confidence interval [CI], 1.26, 1.40) to 1.89 (95% CI, 1.78, 2.00). Child mortality risks are particularly related to maternal exposure to El Niño-like conditions in the 0th–1st and 6th–12th lagged months. The El Niño effects are larger in rural populations and those with unsafe sources of drinking water and less education. Thus, preventive interventions are particularly warranted for the socio-economically disadvantaged.

Date: 2024
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DOI: 10.1038/s41467-024-50467-x

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