Risk factors and causes of stillbirths among pregnant women in Pakistan

Afr Health Sci. 2019 Mar;19(1):1507-1516. doi: 10.4314/ahs.v19i1.24.

Abstract

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.

Keywords: Pakistan; Perinatal mortality; delivery complications; stillbirth causes.

MeSH terms

  • Adult
  • Asphyxia Neonatorum / epidemiology
  • Cause of Death
  • Delivery, Obstetric / methods
  • Female
  • Health Care Surveys
  • Humans
  • Infant, Newborn
  • Male
  • Maternal Age
  • Middle Aged
  • Obstetric Labor Complications*
  • Pakistan / epidemiology
  • Perinatal Mortality*
  • Pregnancy
  • Pregnancy Complications / epidemiology
  • Prenatal Care / statistics & numerical data*
  • Risk Factors
  • Rural Population
  • Socioeconomic Factors
  • Stillbirth / epidemiology*
  • Urban Population