Format

Send to

Choose Destination
Trop Med Int Health. 2017 Jan;22(1):63-73. doi: 10.1111/tmi.12807. Epub 2016 Dec 1.

Trends and risk factors of stillbirths and neonatal deaths in Eastern Uganda (1982-2011): a cross-sectional, population-based study.

Author information

1
Department of Public Health Sciences - Global Health, Karolinska Institutet, Stockholm, Sweden.
2
Maternal and Newborn Centre of Excellence, Makerere University School of Public Health, Kampala, Uganda.
3
The INDEPTH Network Maternal and Newborn Working Group, Iganga-Mayuge Health and Demographic Surveillance Site, Iganga, Uganda.
4
Mental Health Program, Clinical Services Division, Ministry of Health, Kampala, Uganda.
5
Department of International Health, Johns Hopkins University, Baltimore, MD, USA.
6
Faculty of Infectious & Tropical Disease, London School of Hygiene & Tropical Medicine, London, UK.

Abstract

OBJECTIVES:

To identify mortality trends and risk factors associated with stillbirths and neonatal deaths 1982-2011.

METHODS:

Population-based cross-sectional study based on reported pregnancy history in Iganga-Mayuge Health and Demographic Surveillance Site (HDSS) in Uganda. A pregnancy history survey was conducted among women aged 15-49 years living in the HDSS during May-July 2011 (n = 10 540). Time trends were analysed with cubic splines and linear regression. Potential risk factors were examined with multilevel logistic regression with adjusted odds ratios (AOR) and 95% confidence intervals (CI).

RESULTS:

34 073 births from 1982 to 2011 were analysed. The annual rate of decrease was 0.9% for stillbirths and 1.8% for neonatal mortality. Stillbirths were associated with several risk factors: multiple births (AOR 2.57, CI 1.66-3.99), previous adverse outcome (AOR 6.16, CI 4.26-8.88) and grand multiparity among 35- to 49-year-olds (AOR 1.97, CI 1.32-2.89). Neonatal deaths were associated with multiple births (AOR 6.16, CI 4.80-7.92) and advanced maternal age linked with parity of 1-4 (AOR 2.34, CI 1.28-4.25) and grand multiparity (AOR 1.44, CI 1.09-1.90). Education, marital status and household wealth were not associated with the outcomes.

CONCLUSIONS:

The slow decline in mortality rates and easily identifiable risk factors calls for improving quality of care at birth and a rethinking of how to address obstetric risks, potentially a revival of the risk approach in antenatal care.

KEYWORDS:

Ouganda; Uganda; décès périnatal; embarazo; epidemiologic factors; facteurs épidémiologiques; factores epidemiológicos; grossesse; histoire de la reproduction; historia reproductiva; mortinaissance; mortinato; muertes perinatales; perinatal death; pregnancy; reproductive history; stillbirth

PMID:
27910181
DOI:
10.1111/tmi.12807
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center