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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2017

Open Access 01-12-2017 | Research article

Antepartum complications and perinatal mortality in rural Bangladesh

Published in: BMC Pregnancy and Childbirth | Issue 1/2017

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Abstract

Background

Despite impressive improvements in maternal survival throughout the world, rates of antepartum complications remain high. These conditions also contribute to high rates of perinatal deaths, which include stillbirths and early neonatal deaths, but the extent is not well studied. This study examines patterns of antepartum complications and the risk of perinatal deaths associated with such complications in rural Bangladesh.

Methods

We used data on self-reported antepartum complications during the last pregnancy and corresponding pregnancy outcomes from a household survey (N = 6,285 women) conducted in Sylhet district, Bangladesh in 2006. We created three binary outcome variables (stillbirths, early neonatal deaths, and perinatal deaths) and three binary exposure variables indicating antepartum complications, which were antepartum hemorrhage (APH), probable infection (PI), and probable pregnancy-induced hypertension (PIH). We then examined patterns of antepartum complications and calculated incidence rate ratios (IRR) to estimate the associated risks of perinatal mortality using Poisson regression analyses. We calculated population attributable fraction (PAF) for the three antepartum complications to estimate potential risk reductions of perinatal mortality associated them.

Results

We identified 356 perinatal deaths (195 stillbirths and 161 early neonatal deaths). The highest risk of perinatal death was associated with APH (IRR = 3.5, 95% CI: 2.4–4.9 for perinatal deaths; IRR = 3.7, 95% CI 2.3–5.9 for stillbirths; IRR = 3.5, 95% CI 2.0–6.1 for early neonatal deaths). Pregnancy-induced hypertension was a significant risk factor for stillbirths (IRR = 1.8, 95% CI 1.3–2.5), while PI was a significant risk factor for early neonatal deaths (IRR = 1.5, 95% CI 1.1–2.2). Population attributable fraction of APH and PIH were 6.8% and 10.4% for perinatal mortality and 7.5% and 14.7% for stillbirths respectively. Population attributable fraction of early neonatal mortality due to APH was 6.2% and for PI was 7.8%.

Conclusions

Identifying antepartum complications and ensuring access to adequate care for those complications are one of the key strategies in reducing perinatal mortality in settings where most deliveries occur at home.
Literature
1.
Lawn JE, Blencowe H, Oza S, You D, Lee AC, Waiswa P, Lalli M, Bhutta Z, Barros AJ, Christian P, et al. Every newborn: progress, priorities, and potential beyond survival. Lancet (London, England). 2014;384(9938):189–205.CrossRef
2.
Lawn JE, Blencowe H, Waiswa P, Amouzou A, Mathers C, Hogan D, Flenady V, Frøen JF, Qureshi ZU, Calderwood C et al. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016.
3.
Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, Rudan I, Campbell H, Cibulskis R, Li M, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since. Lancet (London, England). 2000;2012(379):2151–61.
4.
Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: When? Where? Why? Lancet (London, England). 2005;365:891–900.CrossRef
5.
World Health Organization. Neonatal and perinatal mortality : country, regional and global estimates. Geneva: World Health Organization; 2006.
6.
Owais A, Faruque ASG, Das SK, Ahmed S, Rahman S, Stein AD. Maternal and antenatal risk factors for stillbirths and neonatal mortality in rural bangladesh: a case-control study. PLoS ONE. 2013;8(11):e80164.CrossRefPubMedPubMedCentral
7.
Vogel JP, Souza JP, Mori R, Morisaki N, Lumbiganon P, Laopaiboon M, Ortiz-Panozo E, Hernandez B, Perez-Cuevas R, Roy M, et al. Maternal complications and perinatal mortality: findings of the World Health Organization multicountry survey on maternal and newborn health. Bjog. 2014;121 Suppl 1:76–88.CrossRefPubMed
8.
Di MS, Say L, Lincetto O. Risk factors for stillbirth in developing countries: a systematic review of the literature. Sex Transm Dis. 2007;34:S11–21.CrossRef
9.
McClure EM, Wright LL, Goldenberg RL, Goudar SS, Parida SN, Jehan I, Tshefu A, Chomba E, Althabe F, Garces A, et al. The global network: a prospective study of stillbirths in developing countries. Am J Obstet Gynecol. 2007;197(3):247.e241–245.CrossRef
10.
Macheku GS, Philemon RN, Oneko O, Mlay PS, Masenga G, Obure J, Mahande MJ. Frequency, risk factors and feto-maternal outcomes of abruptio placentae in Northern Tanzania: a registry-based retrospective cohort study. BMC Pregnancy Childbirth. 2015;15:242.CrossRefPubMedPubMedCentral
11.
Adane AA, Ayele TA, Ararsa LG, Bitew BD, Zeleke BM. Adverse birth outcomes among deliveries at Gondar University Hospital, Northwest Ethiopia. BMC Pregnancy Childbirth. 2014;14(1):1–8.CrossRef
12.
Mamun AA, Padmadas SS, Khatun M. Maternal health during pregnancy and perinatal mortality in Bangladesh: evidence from a large-scale community-based clinical trial. Paediatr Perinat Epidemiol. 2006;20:482–90.CrossRefPubMed
13.
Yucesoy G, Ozkan S, Bodur H, Tan T, Caliskan E, Vural B, Corakci A. Maternal and perinatal outcome in pregnancies complicated with hypertensive disorder of pregnancy: a seven year experience of a tertiary care center. Arch Gynecol Obstet. 2005;273(1):43–9.CrossRefPubMed
14.
Sakornbut E, Leeman L, Fontaine P. Late pregnancy bleeding. Am Fam Physician. 2007;75(8):1199–206.PubMed
15.
Browne JL, Vissers KM, Antwi E, Srofenyoh EK, Van der Linden EL, Agyepong IA, Grobbee DE, Klipstein-Grobusch K. Perinatal outcomes after hypertensive disorders in pregnancy in a low resource setting. Trop Med Int Health. 2015;20(12):1778–86.CrossRefPubMed
16.
Allanson ER, Muller M, Pattinson RC. Causes of perinatal mortality and associated maternal complications in a South African province: challenges in predicting poor outcomes. BMC Pregnancy Childbirth. 2015;15:37.CrossRefPubMedPubMedCentral
17.
McClure EM, Nalubamba-Phiri M, Goldenberg RL. Stillbirth in developing countries. Int J Gynaecol Obstet. 2006;94:82–90.CrossRefPubMed
18.
Goldenberg RL, Thompson C. The infectious origins of stillbirth. Am J Obstet Gynecol. 2003;189:861–73.CrossRefPubMed
19.
RS G. The origins of stillbirth: infectious diseases. Semin Perinatol 2002, 26:75–78
20.
Vergnano S, Sharland M, Kazembe P, Mwansambo C, Health PT. Neonatal sepsis: an international perspective. Arch Dis Child Fetal Neonatal Ed. 2005;90:F220–4.
21.
Sankar MJ, Agarwal R, Deorari AK, Paul VK. Sepsis in the newborn. Indian J Pediatr. 2008;75:261–6.
22.
Killewo J, Anwar I, Bashir I, Yunus M, Chakraborty J. Perceived delay in healthcare-seeking for episodes of serious illness and its implications for safe motherhood interventions in rural Bangladesh. J Health Popul Nutr. 2006;24(4):403–12.PubMedPubMedCentral
23.
Baqui AH, Williams E, El-Arifeen S, Applegate JA, Mannan I, Begum N, Rahman SM, Ahmed S, Black RE, Darmstadt GL. Effect of community-based newborn care on cause-specific neonatal mortality in Sylhet district, Bangladesh: findings of a cluster-randomized controlled trial. J Perinatol. 2016;36(1):71–6.CrossRefPubMed
24.
Baqui AH, El-Arifeen S, Darmstadt GL. Effect of community-based newborn-care intervention package implemented through two service-delivery strategies in Sylhet district, Bangladesh: a cluster-randomised controlled trial. Lancet (London, England). 2008;371:1936–44.CrossRef
25.
Mitra SN, Al-Sabir A, Saha T, Sushil K. Bangladesh demographic and health survey 199–2000. Dhaka: National Institute of Population Research and Training (NIPORT); 2001.
26.
Darmstadt GL, Baqui AH, Choi Y. Validation of community health workers’ assessment of neonatal illness in rural Bangladesh. Bull World Health Organ. 2009;87:12–9.CrossRefPubMed
27.
Filmer D, Pritchett LH. Estimating wealth effects without expenditure data--or tears: an application to educational enrollments in states of India. Demography. 2001;38:115–32.PubMed
28.
29.
Greenland S, Drescher K. Maximum likelihood estimation of the attributable fraction from logistic models. Biometrics. 1993;49:865–72.CrossRefPubMed
30.
National Institute of Population Research and Training (NIPORT), Mitra and Associates (MA), Macro International. Bangladesh demographic and health survey, 2007. Dhaka and Calverton: National Institute of Population Research and Training (NIPORT), Mitra and Associates (MA), Macro International; 2009.
31.
National Institute of Population Research and Training (NIPORT), Ministry of Health and Family Welfare, Mitra and Associates (MA), The DHS program, ICF International. Bangladesh demographic and health survey 2014. Dhaka and RockVille: National Institute of Population Research and Training (NIPORT), Ministry of Health and Family Welfare, Mitra and Associates (MA), The DHS program, ICF International; 2016.
32.
Ellison GT, de Wet T, Matshidze KP, Cooper P. The reliability and validity of self-reported reproductive history and obstetric morbidity amongst birth to ten mothers in Soweto. Curationis. 2000;23(4):76–80.CrossRefPubMed
33.
National Institute of Population Research and Training (NIPORT) MaA, and ICF International. Bangladesh demographic and health survey 2014: key indicators. Dhaka and Rockville: NIPORT, Mitra and Associates, and ICF International; 2015.
Metadata
Title
Antepartum complications and perinatal mortality in rural Bangladesh
Publication date
01-12-2017
Published in
BMC Pregnancy and Childbirth / Issue 1/2017
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-017-1264-1

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