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Stillbirth rate and associated risk factors among 869 750 Latin American hospital births 1982–1986
Author(s) -
Gadow E.C.,
Castilla E.E.,
Lopez Camelo J.,
Queenan J.T.
Publication year - 1991
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/0020-7292(91)90287-f
Subject(s) - medicine , incidence (geometry) , latin americans , infant mortality , obstetrics , fetus , demography , perinatal mortality , epidemiology , pregnancy , mortality rate , public health , developed country , pediatrics , population , environmental health , surgery , philosophy , linguistics , physics , sociology , biology , optics , genetics , nursing
Fetal death is essential to evaluate perinatal outcome. Accurate stillbirth rate however is difficult to obtain; this is especially so in developing countries. Current information was obtained through a clinical‐epidemiological study, ECLAMC, during the 1982–1986 period for a total sample of 869 750 births in 102 hospitals belonging to 11 Latin American countries. The overall stillbirth rate was 2.0%, the highest being in Bolivian (4.4%) and the lowest in Chilean hospitals (0.9%). In all countries there was a high mortality rate among male fetuses. The incidence of stillbirth in multiple pregnancies almost doubled that for singletons. A steady increase with increasing maternal age was observed. The proportion of all births in mothers 35 years of age or older was 10.1%, while the stillbirth proportion among all stillbirths in the same maternal age group was 18.8%. As expected, a higher fetal mortality rate (10.7%) was found in the low birthweight group (≤ 2500 g) than in the group with birthweight greater than 2500 g (0.6%). One out of ten births occurred in the former group. A striking difference was observed in the stillbirth rate between hospitals with free obstetrical care (2.5%) and those in which any type of payment was required (1.4%). Although socioeconomical factors are probably the main factors responsible for fetal death, increased maternal age and a high incidence of low birthweight also contributed greatly to fetal mortality. These risk factors for fetal mortality should be the target of public health actions in these countries.