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Trends and risk factors of stillbirth among women of reproductive age in Pakistan: A multivariate decomposition analysis

BACKGROUND: Every year, 2 million babies are stillborn in the world. Globally, there has been a decline in the stillbirth rate of 2%. Despite advancements in prenatal care and the implementation of new medical technologies, the incidence of early stillbirths remains unchanged. A slight decrease in t...

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Autores principales: Shakeel, Abeera, Kamal, Asifa, Ijaz, Muhammad, Siddiqa, Maryam, Tesema, Getayeneh Antehunegn, Abushal, Tahani
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9996174/
https://www.ncbi.nlm.nih.gov/pubmed/36908442
http://dx.doi.org/10.3389/fpubh.2023.1050136
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author Shakeel, Abeera
Kamal, Asifa
Ijaz, Muhammad
Siddiqa, Maryam
Tesema, Getayeneh Antehunegn
Abushal, Tahani
author_facet Shakeel, Abeera
Kamal, Asifa
Ijaz, Muhammad
Siddiqa, Maryam
Tesema, Getayeneh Antehunegn
Abushal, Tahani
author_sort Shakeel, Abeera
collection PubMed
description BACKGROUND: Every year, 2 million babies are stillborn in the world. Globally, there has been a decline in the stillbirth rate of 2%. Despite advancements in prenatal care and the implementation of new medical technologies, the incidence of early stillbirths remains unchanged. A slight decrease in the rate of late-term stillbirth has been observed. Pakistan ranked third in South Asia for having the highest stillbirth rate. Compared to its neighbors and other developing nations, Pakistan has shown a lack of progress in reducing maternal and neonatal fatalities. Therefore, the purpose of this study is to use a multivariate decomposition analysis to examine the trends and factors that have contributed to the change in the stillbirth rate over time. METHODS: To conduct this study, we used a secondary data analysis approach and analyzed data from the Pakistan Demographic and Health Survey (PDHS) of 2012–2013 and 2017–2018). For the analysis, a total sample of 15,068 births in 2017–2018 and 13,558 births in the PDHS from 2012 to 2013 were taken into account. Using the MVDCMP function within STATA version 15 statistical software, a logit-based multivariate decomposition model was fitted to determine the variables that influence the change in stillbirth. The current study used two cross-sectional surveys to identify important risk factors for stillbirths. RESULTS: Over the past 5 years, Pakistan's stillbirth rate has risen from 3.98 to 5.75%. According to the total multivariate decomposition analysis, the change in coefficient (change in the effect of attributes) accounted for 81.17% of the overall change in the proportion of stillbirths. In contrast, the change in endowment was not statistically significant. Changes in maternal education, individual and community-level wealth status, and mode of delivery all significantly impacted the rate of stillbirths over time. CONCLUSION: Stillbirths increased in Pakistan from 2012 to 2017. Stillbirths are observed more frequently for women residing in Punjab, Sindh, and rural areas. A major concern that is directly related to the prevalence of stillbirths in Pakistan is the lack of accessible, affordable, and high-quality maternal healthcare facilities. Older, overweight, and uneducated women are more likely to have stillbirths than women who deliver vaginally. High parity and short birth intervals also accelerated the rate of stillbirths. An effective remedy to control stillbirths is the provision of accessible and affordable healthcare services. Awareness campaigns for the health education of pregnant women should focus on raising awareness to support better pregnancy outcomes for poor women living in communities with higher education levels. The risk of stillbirth can be reduced by offering free diagnostics for early detection of birth complications in low-resource settings and referring these cases to knowledgeable gynecologists for safe delivery.
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spelling pubmed-99961742023-03-10 Trends and risk factors of stillbirth among women of reproductive age in Pakistan: A multivariate decomposition analysis Shakeel, Abeera Kamal, Asifa Ijaz, Muhammad Siddiqa, Maryam Tesema, Getayeneh Antehunegn Abushal, Tahani Front Public Health Public Health BACKGROUND: Every year, 2 million babies are stillborn in the world. Globally, there has been a decline in the stillbirth rate of 2%. Despite advancements in prenatal care and the implementation of new medical technologies, the incidence of early stillbirths remains unchanged. A slight decrease in the rate of late-term stillbirth has been observed. Pakistan ranked third in South Asia for having the highest stillbirth rate. Compared to its neighbors and other developing nations, Pakistan has shown a lack of progress in reducing maternal and neonatal fatalities. Therefore, the purpose of this study is to use a multivariate decomposition analysis to examine the trends and factors that have contributed to the change in the stillbirth rate over time. METHODS: To conduct this study, we used a secondary data analysis approach and analyzed data from the Pakistan Demographic and Health Survey (PDHS) of 2012–2013 and 2017–2018). For the analysis, a total sample of 15,068 births in 2017–2018 and 13,558 births in the PDHS from 2012 to 2013 were taken into account. Using the MVDCMP function within STATA version 15 statistical software, a logit-based multivariate decomposition model was fitted to determine the variables that influence the change in stillbirth. The current study used two cross-sectional surveys to identify important risk factors for stillbirths. RESULTS: Over the past 5 years, Pakistan's stillbirth rate has risen from 3.98 to 5.75%. According to the total multivariate decomposition analysis, the change in coefficient (change in the effect of attributes) accounted for 81.17% of the overall change in the proportion of stillbirths. In contrast, the change in endowment was not statistically significant. Changes in maternal education, individual and community-level wealth status, and mode of delivery all significantly impacted the rate of stillbirths over time. CONCLUSION: Stillbirths increased in Pakistan from 2012 to 2017. Stillbirths are observed more frequently for women residing in Punjab, Sindh, and rural areas. A major concern that is directly related to the prevalence of stillbirths in Pakistan is the lack of accessible, affordable, and high-quality maternal healthcare facilities. Older, overweight, and uneducated women are more likely to have stillbirths than women who deliver vaginally. High parity and short birth intervals also accelerated the rate of stillbirths. An effective remedy to control stillbirths is the provision of accessible and affordable healthcare services. Awareness campaigns for the health education of pregnant women should focus on raising awareness to support better pregnancy outcomes for poor women living in communities with higher education levels. The risk of stillbirth can be reduced by offering free diagnostics for early detection of birth complications in low-resource settings and referring these cases to knowledgeable gynecologists for safe delivery. Frontiers Media S.A. 2023-02-23 /pmc/articles/PMC9996174/ /pubmed/36908442 http://dx.doi.org/10.3389/fpubh.2023.1050136 Text en Copyright © 2023 Shakeel, Kamal, Ijaz, Siddiqa, Tesema and Abushal. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Shakeel, Abeera
Kamal, Asifa
Ijaz, Muhammad
Siddiqa, Maryam
Tesema, Getayeneh Antehunegn
Abushal, Tahani
Trends and risk factors of stillbirth among women of reproductive age in Pakistan: A multivariate decomposition analysis
title Trends and risk factors of stillbirth among women of reproductive age in Pakistan: A multivariate decomposition analysis
title_full Trends and risk factors of stillbirth among women of reproductive age in Pakistan: A multivariate decomposition analysis
title_fullStr Trends and risk factors of stillbirth among women of reproductive age in Pakistan: A multivariate decomposition analysis
title_full_unstemmed Trends and risk factors of stillbirth among women of reproductive age in Pakistan: A multivariate decomposition analysis
title_short Trends and risk factors of stillbirth among women of reproductive age in Pakistan: A multivariate decomposition analysis
title_sort trends and risk factors of stillbirth among women of reproductive age in pakistan: a multivariate decomposition analysis
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9996174/
https://www.ncbi.nlm.nih.gov/pubmed/36908442
http://dx.doi.org/10.3389/fpubh.2023.1050136
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