Risk factors and causes of stillbirths among pregnant women in Pakistan

BACKGROUND: Globally 3 million stillbirths occur per year, and Pakistan is ranked 3(rd) 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.