Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Reproductive Health
Published in: Reproductive Health 2/2015

Open Access 01-12-2015 | Research

Trends in perinatal deaths from 2010 to 2013 in the Guatemalan Western Highlands

Authors: Ana Garces, Elizabeth M Mcclure, K Michael Hambidge, Nancy F Krebs, Lester Figueroa, Marta Lidia Aguilar, Janet L Moore, Robert L Goldenberg

Published in: Reproductive Health | Special Issue 2/2015

Login to get access

Abstract

Background

While progress has been made in reducing neonatal mortality in Guatemala, stillbirth and maternal mortality rates remain high, especially among the indigenous populations, which have among the highest adverse pregnancy-related mortality rates in Guatemala.

Methods

We conducted a prospective study in the Western Highlands of Guatemala from 2010 through 2013, enrolling women during pregnancy with follow-up through 42-days postpartum. All pregnant women were identified and enrolled by study staff in the clusters in the Chimaltenango region for which we had 4 years of data. Enrolment usually occurred during the antenatal period; women were also visited following delivery and 42-days postpartum to collect outcomes. Measures of antenatal and delivery care were also obtained.

Results

Approximately four thousand women were enrolled annually (3,869 in 2010 to 4,570 in 2013). The stillbirth rate decreased significantly, from 22.0 per 1000 births (95% CI 16.6, 29.0) in 2010 to 16.7 (95% CI 13.5, 20.6) in 2013 (p-value 0.0223). The perinatal mortality rate decreased from 43.9 per 1,000 births (95% CI 36.0, 53.6) to 31.6 (95% CI 27.2, 36.7) (p-value 0.0003). The 28-day neonatal mortality rate decreased from 28.9 per 1000 live births (95% CI 25.2, 33.2) to 21.7 (95% CI 17.5, 26.9), p-value 0.0004. The maternal mortality rate was 134 per 100,000 in 2010 vs. 113 per 100,000 in 2013. Over the same period, hospital birth rates increased from 30.0 to 50.3%.

Conclusions

In a relatively short time period, significant improvements in neonatal, fetal and perinatal mortality were noted in an area of Guatemala with a history of poor pregnancy outcomes. These changes were temporally related to major increases in hospital-based delivery with skilled birth attendants, as well as improvements in the quality of delivery care, neonatal care, and prenatal care.
Appendix
Available only for authorised users
Literature
1.
Oestergaard ZM, Inoue M, Yoshida S, Retno Mahanani W, Gore FM, Cousens S, et al: Neonatal Mortality Levels for 193 Countries in 2009 with Trends Since 1990: A Systematic Analysis of Progress, Projections, and Priorities. PLoS Medicine. 2011, 8 (8): e1001080-10.1371/journal.pmed.1001080.CrossRefPubMedPubMedCentral
2.
McClure EM, Pasha O, Goudar SS, Chomba E, Garces A, Tshefu A, Goldenberg RL, et al: Epidemiology of stillbirth in low - middle income countries: A Global Network Study. Acta Obstetricia Gynecology Scandanivia. 2011, 90 (12): 1379-1385. 10.1111/j.1600-0412.2011.01275.x.CrossRef
3.
Lawn JE, Cousens S, Zupan J: 4 million neonatal deaths: When? Where? Why?. Lancet. 2005, 365 (9462): 9-18.CrossRef
4.
Blencowe H, Cousens S, Chou D, Oestergaard M, Say L, Moller A, et al: Born Too Soon: The global epidemiology of 15 million preterm births. Reproductive Health. 2013, 10 (Suppl 1): S2-10.1186/1742-4755-10-S1-S2.CrossRefPubMedPubMedCentral
5.
Wang H, Liddell CA, Coates M, et al: Global, regional and national levels of neonatal, infant, and under - 5 mortality during 1990 - 2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014, 384 (9947): 957-979. 10.1016/S0140-6736(14)60497-9.CrossRefPubMedPubMedCentral
6.
Oza S, Cousens S, Lawn JE: Estimation of daily risk of neonatal death, including the day of birth, in 186 countries in 2013: a vital registration and modelling - based study. Lancet Global Health. 2014, 2 (11): e635-e644. 10.1016/S2214-109X(14)70309-2.CrossRefPubMed
7.
Goldenberg RL, McClure EM: Maternal, fetal and neonatal mortality: lessons learned from historical changes in high income countries and their potential application to low-income countries. Maternal Health, Neonatology and Perinatology. 2015, 1: 3-CrossRefPubMedPubMedCentral
8.
Saleem S, McClure E, Goudar SS, Patel A, Esamai F, Garces A, Goldenberg RL: A prospective study of maternal, fetal and neonatal deaths in low - and middle-income countries. Bulletin of the World Health Organization. 2014, 92 (8): 545-620.CrossRef
9.
Knoll Rajaranatnam J, Marcus JR, Flaxman AD, Wang H, Levin-Rector A, Dwyer L, et al: Neonatal, postneonatal, childhood, and under -5 mortality for 187 countries, 1970 - 2010: a systematic analysis of progress towards Millennium Development Goal 4. Lancet. 2010, 375 (9730): 1988-2008. 10.1016/S0140-6736(10)60703-9.CrossRef
10.
Lawn J, Shibuya K, Stein C: No cry at birth: global estimates of intrapartum stillbirths and intrapartum - related neonatal deaths. Bulletin of the World Health Organization. 2005, 83 (6): 409-417.PubMedPubMedCentral
11.
McClure EM, Goldenberg RL, Bann CM: Maternal mortality, stillbirth and measures of obstetric care in developing and developed countries. International Journal Gynec Obstetrics. 2007, 96 (2): 139-146. 10.1016/j.ijgo.2006.10.010.CrossRef
12.
Goldenberg RL, McClure EM, Bhutta ZA, Belizan JM, Reddy UM, Rubens CE, et al: Stillbirths: the vision for 2020. Lancet. 2011, 377 (9779): 1798-1805. 10.1016/S0140-6736(10)62235-0.CrossRefPubMed
13.
Mason E, McDougall L, Lawn JE, Gupta A, Claeson M, Pillay Y, et al: From evidence to action to deliver a healthy start for the next generation. Lancet. 2014, 384 (9941): 455-467. 10.1016/S0140-6736(14)60750-9.CrossRefPubMed
14.
Garces A, Mcclure EM, Chomba E, Patel A, Pasha O, Tshefu A, Goldenberg RL: Home birth attendants in low income countries: who are they and what do they do?. BMC Pregnancy and Childbirth. 2012, 12 (34): 1-9.
15.
16.
17.
Ministry of Public Health and Social Assistance of Guatemala, National Statistics Institute: 2008 - 2009 National Maternal Infant Health Survey. Guatemala Ministry of Public Health. 2011
Metadata
Title
Trends in perinatal deaths from 2010 to 2013 in the Guatemalan Western Highlands
Authors
Ana Garces
Elizabeth M Mcclure
K Michael Hambidge
Nancy F Krebs
Lester Figueroa
Marta Lidia Aguilar
Janet L Moore
Robert L Goldenberg
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Reproductive Health / Issue Special Issue 2/2015
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/1742-4755-12-S2-S14

Other articles of this Special Issue 2/2015

Reproductive Health 2/2015 Go to the issue

Research

Data quality monitoring and performance metrics of a prospective, population-based observational study of maternal and newborn health in low resource settings

Research

Establishment of a Maternal Newborn Health Registry in the Belgaum District of Karnataka, India

Research

Adverse maternal and perinatal outcomes in adolescent pregnancies: The Global Network’s Maternal Newborn Health Registry study

Research

The Global Network Maternal Newborn Health Registry: a multi-national, community-based registry of pregnancy outcomes

Research

Lost to follow-up among pregnant women in a multi-site community based maternal and newborn health registry: a prospective study

Research

A prospective population-based study of maternal, fetal, and neonatal outcomes in the setting of prolonged labor, obstructed labor and failure to progress in low- and middle-income countries