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Maternal social characteristics and mortality from injuries among infants and toddlers in Estonia
  1. Sanna Tiikkaja1,
  2. Kaja Rahu2,
  3. Ilona Koupil3,
  4. Mati Rahu2
  1. 1 Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden;
  2. 2 Department of Epidemiology and Biostatistics, National Institute for Health Development, Estonia;
  3. 3 Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Sweden
  1. E-mail: sanna.tiikkaja{at}


Background: Injuries are a major cause of ill health among children, with a social gradient in child injuries documented in many countries. We investigated how maternal socio-demographic characteristics affect injury mortality among Estonian infants and toddlers.

Methods: A population-based study using linkage of data from the Estonian Medical Birth Registry with Mortality Database. 148,521 children born 1992-2002 were followed for injury mortality (ICD-9 E800-E999) from birth to third birthday. Associations of maternal age, education, marital status, nationality, place of residence, and child's birth order and multiplicity with risk of injury death were studied in logistic regression.

Results: Maternal age (<20 years compared to ≥30 years OR=2.12; 95% CI: 1.00-4.51), education (basic compared to secondary or higher OR=3.22; 95% CI: 2.12-4.87), marital status (single, divorced or widowed compared to married OR=2.74; 95% CI: 1.53-4.91), nationality (other compared to Estonian: OR=2.00; 95% CI:1.32-3.02), birth order (fourth or higher compared to first: OR=6.66; 95% CI: 3.42-12.99), and multiple birth (twin or triplet compared to singleton: OR=3.12; 95% CI: 1.44-6.73) affected the risk of injury death among infants (<1 year). Among toddlers (1–2 years), boys were at higher risk than girls (OR=1.75; 95% CI: 1.15-2.66) and low mother's education (basic compared to secondary or higher OR=2.08; 95% CI: 1.28-3.37) and high birth order (fourth or higher compared to first: OR=7.88; 95% CI: 3.90-15.90) increased the risk of injury death.

Conclusions: Maternal socio-demographic characteristics are associated with injury mortality among infants and toddlers. Substantial variation in injury mortality rates within Estonia suggests potential for prevention.

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