Risk factors and causes of stillbirths among pregnant women in Pakistan

Background: Globally 3 million stillbirths occur per year, and Pakistan is ranked 3rd among the countries having the highest burden. Despite being a major public health problem, efforts to reduce this figure are insufficient.Objective: The aim of the study was to identify and measure the inequalities in stillbirth associated risk factors, causes and fertility risk behaviors.Methods: Data were derived from the Pakistan Demographic and Health Surveys (PDHS) 1990-2013. Inequalities on determi- nants were evaluated using rate differences and rate ratios; time trends computed with annualized reduction rate (ARR).Results: Overall ARR determined for stillbirth was -12.52 percent per annum. The high ARR were recorded for mothers age <20, urban areas, educated mothers and for highest wealth quintile. The relative inequalities were most pronounced for wealth quintiles, education and age of mothers. Stillbirth causes were unexplained antepartum (33%), unexplained intrapartum (21%), intrapartum asphyxia (21%) and antepartum maternal disorders (19%). The high fertility risk behavior was found in mothers with age >34 and birth order >3.Conclusion: The study concluded that to achieve gain in child survival, there is need to promote antenatal care, birth spacing, and family planning programs in developing countries.Keywords: Perinatal mortality, stillbirth causes, delivery complications, Pakistan

Risk factors and causes of stillbirths among pregnant women in Pakistan

Background: Globally 3 million stillbirths occur per year, and Pakistan is ranked 3rd among the countries having the highest burden. Despite being a major public health problem, efforts to reduce this figure are insufficient. Objective: The aim of the study was to identify and measure the inequalities in stillbirth associated risk factors, causes and fertility risk behaviors. Methods: Data were derived from the Pakistan Demographic and Health Surveys (PDHS) 1990-2013. Inequalities on determinants were evaluated using rate differences and rate ratios; time trends computed with annualized reduction rate (ARR). Results: Overall ARR determined for stillbirth was -12.52 percent per annum. The high ARR were recorded for mothers age <20, urban areas, educated mothers and for highest wealth quintile. The relative inequalities were most pronounced for wealth quintiles, education and age of mothers. Stillbirth causes were unexplained antepartum (33%), unexplained intrapartum (21%), intrapartum asphyxia (21%) and antepartum maternal disorders (19%). The high fertility risk behavior was found in mothers with age >34 and birth order >3. Conclusion: The study concluded that to achieve gain in child survival, there is need to promote antenatal care, birth spacing, and family planning programs in developing countries. DOI: https://dx.doi.org/10.4314/ahs.v19i1.24 Cite as: Afshan K, Narjis G, M Q. Risk factors and causes of stillbirths among pregnant women in Pakistan. Afri Health Sci. 2019;19(1). 1507-1516. https://dx.doi.org/10.4314/ahs.v19i1.2