A Meta-Analysis of Socio-Demographic Factors for Perinatal Mortality in Developing Countries: A Subgroup Analysis of the National Surveys and Small Scale Studies

Berhan, Yifru; Berhan, Asres

doi:10.4314/ejhs.v24i0.5s

Cited by 15 publications

(11 citation statements)

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“…Living in rural areas can be a risk for pregnant women since quality health services and infrastructure are usually more accessible in urban centres. Similar to our study, the meta-analysis done on developing countries showed that perinatal mortality was significantly higher in rural areas [20]. In Tanzania, a demographic health survey which was conducted in 2010 found that both women living in urban areas as well as in rural areas have increased risk of perinatal death [21].…”

Section: District Of Residencesupporting

confidence: 83%

Perinatal Mortality and Associated Risk Factors among Singleton Babies in Unguja Island, Zanzibar

Bakar¹,

Manongi²,

Mmbaga³

et al. 2019

Health

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Background: Perinatal mortality is a major public health problem, particularly in developing countries where three quarters of neonatal deaths happen in the first week of life. Therefore, it is crucial to understand factors associated with perinatal mortality in order to design strategies and interventions that will improve newborn outcomes. Methods: A prospective cohort study was carried out, whereby pregnant women with gestational age ≥ 28 weeks were enrolled. Interviews were conducted during antenatal booking using structured questionnaire. Follow-up visits were made within 48 hours after delivery and on seventh day post delivery. Results: A total of 959 pregnant women were enrolled; 38 were lost to follow-up prior delivery. The remaining 921 participants, resulting in PMR of 45.5 per 1000 births. Over half of the deaths were stillbirths (SBR 29.6 per 1000 births) and early neonatal deaths (ENMR 16.8 per 1000 live births). Using Generalized Linear Model (GLM), risk factors associated with perinatal mortality included: maternal age ≥ 35 years (ARR 3.0, 95% CI: 1.0 to 9.0), nulliparous women (ARR 4.2, 95% CI: 1.6 to 11.1), assisted vaginal delivery (ARR 5.1, 95% CI: 1.4 to 19.0), home delivery (ARR 3.3, 95% CI: 1.6 to 6.6), previous newborn death (ARR 4.0, 95% CI: 1.5 to 10.1), pregnancy-induced hypertension (ARR 4.8, 95% CI: 2.4 to 9.4), herbal use during labour (ARR 2.4, 95% CI: 1.2 to 5.1) and newborn asphyxia (ARR 5.9, 95% CI: 1.3 to 26.5). Conclusions: Perinatal mortality was found to be high in Zanzibar. Healthcare providers should pay special attention to women with pregnancy-induced hypertension and nulliparous women throughout How to cite this paper:

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Section: District Of Residencesupporting

confidence: 83%

Perinatal Mortality and Associated Risk Factors among Singleton Babies in Unguja Island, Zanzibar

Bakar¹,

Manongi²,

Mmbaga³

et al. 2019

Health

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show abstract

“…The high TFR among the rural and uneducated women might have contributed to the increased risk of maternal and perinatal mortality in this group of women as the national surveys have already demonstrated ( 13 – 15 ). Another article has also shown a high proportion of maternal and perinatal mortality among rural and uneducated women, specifically in Ethiopia and some other SSA countries ( 20 ). Furthermore, as shown in Figure 3 , the Pearson correlation coefficient (r) has demonstrated a positive and strong association of maternal mortality ratio (MMR) with the TFR in 45 African countries (r = 0.6; P < 0.0001).…”

Section: Resultsmentioning

confidence: 99%

“…As the regression lines showed, it seems that every increased birth has been associated with increased risk of maternal and perinatal deaths. However, it should be noted that there are several socio-demographic and obstetric factors that could determine maternal and perinatal outcome ( 20 – 24 ).…”

Section: Resultsmentioning

confidence: 99%

Reasons for Persistently High Maternal and Perinatal Mortalities in Ethiopia: Part II-Socio-Economic and Cultural Factors

Berhan¹,

Berhan²

2014

Ethiop J Health Sci

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BACKGROUND: The major causes of maternal and perinatal deaths are mostly pregnancy related. However, there are several predisposing factors for the increased risk of pregnancy related complications and deaths in developing countries. The objective of this review was to grossly estimate the effect of selected socioeconomic and cultural factors on maternal mortality, stillbirths and neonatal mortality in Ethiopia. METHODS: A comprehensive literature review was conducted focusing on the effect of total fertility rate (TFR), modern contraceptive use, harmful traditional practice, adult literacy rate and level of income on maternal and perinatal mortalities. For the majority of the data, regression analysis and Pearson correlation coefficient were used as a proxy indicator for the association of variables with maternal, fetal and neonatal mortality. RESULTS: Although there were variations in the methods for estimation, the TFR of women in Ethiopia declined from 5.9 to 4.8 in the last fifteen years, which was in the middle as compared with that of other African countries. The preference of injectable contraceptive method has increased by 7-fold, but the unmet contraceptive need was among the highest in Africa. About 50% reduction in female genital cutting (FGC) was reported although some women's attitude was positive towards the practice of FGC. The regression analysis demonstrated increased risk of stillbirths, neonatal and maternal mortality with increased TFR. The increased adult literacy rate was associated with increased antenatal care and skilled person attended delivery. Low adult literacy was also found to have a negative association with stillbirths and neonatal and maternal mortality. A similar trend was also observed with income. CONCLUSION: Maternal mortality ratio, stillbirth rate and neonatal mortality rate had inverse relations with income and adult education. In Ethiopia, the high total fertility rate, low utilization of contraceptive methods, low adult literacy rate, low income and prevalent harmful traditional practices have probably contributed to the high maternal mortality ratio, stillbirth and neonatal mortality rates.

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“…Though previous studies from different countries found associations of socioeconomic conditions with early neonatal deaths [ 20 , 37 ], recent analyses from several other studies found that socioeconomic inequalities in neonatal mortality in low and middle-income countries are falling. The explanation that has been put forward for the reduction of these inequalities is that the ‘diminution of inequalities’ associated with maternal and neonatal health service utilization [ 38 , 54 , 55 ].…”

Section: Discussionmentioning

confidence: 99%

Determinants of early neonatal mortality in Afghanistan: an analysis of the Demographic and Health Survey 2015

et al. 2018

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BackgroundNeonatal mortality is declining slowly compared to under-five mortality in many developing countries including Afghanistan. About three-fourths of these deaths occur in the early neonatal period (i.e., the first week of life). Although a number of studies investigated determinants of early neonatal mortality in other countries, there is a lack of evidence regarding this in Afghanistan. This study investigated determinants of early neonatal mortality in Afghanistan.MethodsData from the Afghanistan Demographic and Health Survey 2015 (AfDHS 2015) were analyzed. After reporting the weighted frequency distributions of selected factors, a multilevel logistic regression model revealed adjusted associations of factors with early neonatal mortality.ResultsA total of 19,801 weighted live-births were included in our analysis; 266 (1.4%) of the newborns died in this period. Multivariable analysis found that multiple gestations (adjusted odds ratio (AOR): 9.3; 95% confidence interval (CI): 5.7–15.0), larger (AOR: 2.9; 95% CI: 2.2–3.8) and smaller (AOR: 1.8; 95% CI: 1.2–2.6) than average birth size, maternal age ≤ 18 years (AOR: 1.8; 95% CI: 1.1–3.2) and ≥ 35 years (AOR: 1.7; 95% CI: 1.3–2.3), and birth interval of < 2 years (AOR: 2.6; 95% CI: 1.4–4.9) had higher odds of early neonatal mortality. On the other hand, antenatal care by a skilled provider (AOR: 0.7; 95% CI: 0.5–0.9), facility delivery (AOR: 0.7; 955 CI: 0.5–0.9), paternal higher education level (AOR: 0.7; 95% CI: 0.5–1.0), living in north-western (AOR: 0.3; 95% CI: 0.1–0.6), central-western regions (AOR: 0.5; 95% CI: 0.3–0.9) and in a community with higher maternal education level (AOR: 0.4; 95% CI: 0.2–0.9) had negative association.ConclusionsSeveral individual, maternal and community level factors influence early neonatal deaths in Afghanistan; significance of the elements of multiple levels indicates that neonatal survival programs should follow a multifaceted approach to incorporate these associated factors. Programs should focus on birth interval prolongation with the promotion of family planning services, utilization of antenatal care and institutional delivery services along with management of preterm and sick infants to prevent this large number of deaths in this period.

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A Meta-Analysis of Socio-Demographic Factors for Perinatal Mortality in Developing Countries: A Subgroup Analysis of the National Surveys and Small Scale Studies

Cited by 15 publications

References 55 publications

Perinatal Mortality and Associated Risk Factors among Singleton Babies in Unguja Island, Zanzibar

Perinatal Mortality and Associated Risk Factors among Singleton Babies in Unguja Island, Zanzibar

Reasons for Persistently High Maternal and Perinatal Mortalities in Ethiopia: Part II-Socio-Economic and Cultural Factors

Determinants of early neonatal mortality in Afghanistan: an analysis of the Demographic and Health Survey 2015

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