Sociodemographic factors associated with infant abandonment in maternity hospitals in Kazakhstan: a case–control study

doi:10.1016/j.puhe.2015.04.009

Public Health

Volume 129, Issue 7, July 2015, Pages 1010-1013

https://doi.org/10.1016/j.puhe.2015.04.009 Get rights and content

Highlights

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We studied factors associated with abandonment of infants in maternity wards in Kazakhstan.
•
Being unmarried, having an unwanted pregnancy and a low birth weight baby are predictors of infant abandonment.
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Greater openness and more research are needed for identification of women at-risk and development of preventive programmes.

Introduction

The phenomenon of abandonment of infants is poorly understood and remains one of the most understudied public health issues with limited evidence from research, no clear policy or systematic collection of data on abandoned or surrendered infants in either the UK or the USA.1, 2, 3, 4 Although the evidence on factors associated with infant abandonment is limited, it is often linked to social circumstances.1, 2 The rates of abandonment tend to increase during economic hardships.⁵ Women who abandon their children are more likely to be young, poor, unmarried, have low education and social support, and having an unwanted pregnancy.⁶

Countries of the former Soviet Union experienced tremendous economic hardships during transition from communist to market economy accompanied by impoverishment by the majority of the population, decrease in life expectancy and quality of life. A dramatic increase in the number of abandoned and institutionalized children has been reported from Russia during the 1990s often linked to the HIV epidemic.⁷ Institutionalized children in Russia have been reported to be vulnerable to developmental delay, cognitive impairment, chronic health problems, homelessness and suicide.⁸

Kazakhstan is the second largest country among the former USSR with a similar path through transition as observed in Russia and many other former Soviet republics. Kazakhstan is a multi-ethnic state with a total population of 16.7 million (2012). Kazakhs account for 64.6% of the population and the most populous ethnic minority are Russians (22.4%). Life expectancy is among the lowest in the European WHO region: 63.6 years for men and 73.5 years for women in 2009.⁹ At the same time, the proportion of children in institutional care in Kazakhstan is 1670 per 1,00,000, which is the highest among all transitional economies of the former Soviet Union and is among the highest in the world representing a considerable public health problem.¹⁰ However, little is known about determinants or consequences of infant abandonment in Kazakhstan.

We studied sociodemographic factors and factors linked to the index pregnancy associated with infant abandonment shortly after birth in an urban Kazakhstani setting.

Section snippets

Methods

This case–control study was conducted in the town of Semey (former Semipalatinsk) located in the northeastern province of East Kazakhstan. The town is internationally known for being the main Soviet nuclear weapons test site until 1991. The population of Semey is 331.5 thousand (2012) and consists mainly of Kazakhs (63%) and Russians (30%) with other ethnic groups constituting less than 7%. There are three maternity hospitals in the town with 5916 births in 2012 (birth rate 17.8 per 1000).

Cases

Results

Altogether, there were 17 (0.3% of all births in the town) women who gave up their infants shortly after birth in maternity hospitals during the one-year period. Crude analyses (Table 1) revealed that these mothers were significantly more likely to be teenagers, had no permanent income and were single or cohabiting. Maternal ethnic background, place of residence and parity were not associated with the odds for abandonment while the findings for maternal education were inconclusive. Pregnancies

Discussion

This is to the best of our knowledge the first study on factors associated with infant abandonment in Central Asian republics of the former Soviet Union. Kazakhstan has the highest proportion of institutionalized children in the European WHO region and our results can be considered as the first step towards development of a strategy for early identification of mothers who are at risk of abandoning their infants with further aims to develop effective interventions for prevention of infant

Acknowledgements

The authors thank all the women who participated in the study and medical personnel at the maternity hospitals for their support.

Ethical approval

The study was approved by the ethics committee of the Semey State Medical University. All women were informed about the aims of the study and signed informed contest.

Funding

No external funding.

Competing interests

The authors declare no competing interests.

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Abandoned babies and absent policies
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There are more references available in the full text version of this article.

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Citation Excerpt :
Birth weight of children born from PE pregnancy was significantly lower in case of early onset PE and constituted 1565 g in this study. Apart from associated health problems, low birth weight causes other considerations as according to the Kazakhstani study, low birth weight is an important factor for child abandonment at birth [45]. This study has certain limitations that mostly come from its cross-sectional design and retrospective nature that do not enable evaluation of causative factors.
Pre-eclampsia (PE) still significantly contributes to maternal and neonatal morbidity and mortality. This study aimed at evaluation of the prevalence of PE among Kazakhstani women and on elucidation of the associated maternal and neonatal outcomes.
The study followed a retrospective cross-sectional design and was based on the data obtained from the electronic patient registry comprising health records of all patients hospitalized to maternal facilities of Kazakhstan over the period of one year. The diagnosis of PE was made on the basis of criteria established by International Society for the Study of Hypertension in Pregnancy.
Out of 2548 patients, 2408 (94.5%) were non-PE cases, while 54 (2.1%) were early-onset PE cases and 86 records (3.4%) were late-onset PE cases. Birth weight of children born from PE pregnancy was significantly lower in pregnancies complicated with early onset PE and constituted 1565 g. Postpartum hemorrhage was more prevalent in pregnancies complicated with PE.
The data obtained are needed to tailor public health interventions targeted on a reduction of PE problem in Kazakhstan.
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2018, Evolution and Human Behavior
Citation Excerpt :
Newborns that were abandoned in modern Kazakhstan were more likely to have low birth weight (Yelissinova et al., 2015). Many of these same factors (poverty, health) still tragically result in modern newborn abandonment (Bradley, 2003; Yelissinova et al., 2015). Adults have negative perceptions and responses to infant facial cues of health that may relate to information about a number of factors that are related to infant survival, including: body weight (McCormick, 1985; Volk et al., 2007; Volk, Lukjanczuk, & Quinsey, 2005), Fetal Alcohol Syndrome (Waller, Volk, & Quinsey, 2004), Down's syndrome (Yamamoto, Ariely, Chi, Langleben, & Elman, 2009), cleft lip (Parsons et al., 2011; Rayson et al., 2016).
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Healing Body and Soul: Islamic Morality, Practitioner Obligations and Extramarital Pregnancy
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Short CommunicationSociodemographic factors associated with infant abandonment in maternity hospitals in Kazakhstan: a case–control study

Highlights

Introduction

Section snippets

Methods

Results

Discussion

Acknowledgements

Ethical approval

Funding

Competing interests

First page preview

Abandoned babies and absent policies

Health Policy

Abandoned babies in the UK – a review utilizing media reports

Child Care Health Dev

The number of illegally abandoned and legally surrendered newborns in the state of Texas estimated from news stories, 1996–2006

Child Maltreat

Perspectives on newborn abandonment

Pediatr Emerg Care

Health impacts of rapid economic changes in Thailand

Soc Sci Med

Short Communication
Sociodemographic factors associated with infant abandonment in maternity hospitals in Kazakhstan: a case–control study