Nigeria is one of the countries with the highest Under-5 Mortality rates (U5M) estimated
at 117 deaths/1000 live births. Despite public health control initiatives, no significant
improvement in U5M has been demonstrated. The purpose of the study was to determine
whether history of Adverse Pregnancy Outcomes (APO) and maternal socioeconomic
factors could predict the death of children before their fifth birthday, using the life course
health development and fetal programming theories. The study population was women in
their reproductive age (15- 49 years). The study was a secondary data analysis of the
datasets obtained from three Nigeria Demographic and Health Surveys (2003, 2008, and
2013). Complex samples multivariate logistic regression was used to determine the
associations among variables. The results showed that lower education level (p < 0.001),
lower income level (p <0.05), rural residential setting (p< 0.01), and lower
socioeconomic status index (p < 0.001) of women were statistically significant predictors
of U5M. APO was not statistically associated with U5M (p > 0.05). This concludes that
children of women with low socioeconomic factors and status index could be at higher
risk of death within the first 5 years of their lives, and women with history of APO stand
no greater risk of losing their under-5 children. The study would contribute to positive
social change among women in Nigeria through early identification of women whose
children may be at risk of U5M and provision of evidence-based advocacy to urge
increased government and public attention to women and child welfare.