The burden of stillbirths in low resource settings in Latin America: Evidence from a network using an electronic surveillance system
To determine stillbirth ratio and its association with maternal, perinatal, and delivery characteristics, as well as geographic differences in Latin American countries (LAC). We analysed data from the Perinatal Information System of the Latin American Center for Perinatology and Human Development (C...
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creator | de Mucio, Bremen Sosa, Claudio Colomar, Mercedes Mainero, Luis Cruz, Carmen M Chévez, Luz M Lopez, Rita Carrillo, Gema Rizo, Ulises Saint Hillaire, Erika E Arriaga, William E Guadalupe Flores, Rosa M Ochoa, Carlos Gonzalez, Freddy Castro, Rigoberto Stefan, Allan Moreno, Amanda Metelus, Sherly Souza, Renato T Costa, Maria L Luz, Adriana G Sousa, Maria H Cecatti, José G Serruya, Suzanne J |
description | To determine stillbirth ratio and its association with maternal, perinatal, and delivery characteristics, as well as geographic differences in Latin American countries (LAC).
We analysed data from the Perinatal Information System of the Latin American Center for Perinatology and Human Development (CLAP) between January 2018 and June 2021 in 8 health facilities from five LAC countries (Bolivia, Guatemala, Honduras, Nicaragua, and the Dominican Republic). Maternal, pregnancy, and delivery characteristics, in addition to pregnancy outcomes were reported. Estimates of association were tested using chi-square tests, and P < 0.05 was regarded as significant. Bivariate analysis was conducted to estimate stillbirth risk. Prevalence ratios (PR) with their 95% confidence intervals (CI) for each predictor were reported.
In total, 101,852 childbirths comprised the SIP database. For this analysis, we included 99,712 childbirths. There were 762 stillbirths during the study period; the Stillbirth ratio of 7.7/1,000 live births (ranged from 3.8 to 18.2/1,000 live births across the different maternities); 586 (76.9%) were antepartum stillbirths, 150 (19.7%) were intrapartum stillbirths and 26 (3.4%) with an ignored time of death. Stillbirth was significantly associated with women with diabetes (PRadj 2.36; 95%CI [1.25-4.46]), preeclampsia (PRadj 2.01; 95%CI [1.26-3.19]), maternal age (PRadj 1.04; 95%CI [1.02-1.05]), any medical condition (PRadj 1.48; 95%CI [1.24-1.76, and severe maternal outcome (PRadj 3.27; 95%CI [3.27-11.66]).
Pregnancy complications and maternal morbidity were significantly associated with stillbirths. The stillbirth ratios varied across the maternity hospitals, which highlights the importance for individual surveillance. Specialized antenatal and intrapartum care remains a priority, particularly for women who are at a higher risk of stillbirth. |
doi_str_mv | 10.1371/journal.pone.0296002 |
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We analysed data from the Perinatal Information System of the Latin American Center for Perinatology and Human Development (CLAP) between January 2018 and June 2021 in 8 health facilities from five LAC countries (Bolivia, Guatemala, Honduras, Nicaragua, and the Dominican Republic). Maternal, pregnancy, and delivery characteristics, in addition to pregnancy outcomes were reported. Estimates of association were tested using chi-square tests, and P < 0.05 was regarded as significant. Bivariate analysis was conducted to estimate stillbirth risk. Prevalence ratios (PR) with their 95% confidence intervals (CI) for each predictor were reported.
In total, 101,852 childbirths comprised the SIP database. For this analysis, we included 99,712 childbirths. There were 762 stillbirths during the study period; the Stillbirth ratio of 7.7/1,000 live births (ranged from 3.8 to 18.2/1,000 live births across the different maternities); 586 (76.9%) were antepartum stillbirths, 150 (19.7%) were intrapartum stillbirths and 26 (3.4%) with an ignored time of death. Stillbirth was significantly associated with women with diabetes (PRadj 2.36; 95%CI [1.25-4.46]), preeclampsia (PRadj 2.01; 95%CI [1.26-3.19]), maternal age (PRadj 1.04; 95%CI [1.02-1.05]), any medical condition (PRadj 1.48; 95%CI [1.24-1.76, and severe maternal outcome (PRadj 3.27; 95%CI [3.27-11.66]).
Pregnancy complications and maternal morbidity were significantly associated with stillbirths. The stillbirth ratios varied across the maternity hospitals, which highlights the importance for individual surveillance. Specialized antenatal and intrapartum care remains a priority, particularly for women who are at a higher risk of stillbirth.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0296002</identifier><identifier>PMID: 38134193</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Births ; Bivariate analysis ; Diabetes mellitus ; Diagnosis ; Distribution ; Electronics ; Evaluation ; Female ; Health care facilities ; Hospital facilities ; Humans ; Information systems ; Latin America - epidemiology ; Maternal mortality ; Morbidity ; Pre-eclampsia ; Pregnancy ; Pregnancy complications ; Public health administration ; Resource-Limited Settings ; Risk Factors ; Still-birth ; Stillbirth ; Stillbirth - epidemiology ; Surveillance systems ; Womens health</subject><ispartof>PloS one, 2023-12, Vol.18 (12), p.e0296002-e0296002</ispartof><rights>Copyright: © 2023 de Mucio et al. 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This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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We analysed data from the Perinatal Information System of the Latin American Center for Perinatology and Human Development (CLAP) between January 2018 and June 2021 in 8 health facilities from five LAC countries (Bolivia, Guatemala, Honduras, Nicaragua, and the Dominican Republic). Maternal, pregnancy, and delivery characteristics, in addition to pregnancy outcomes were reported. Estimates of association were tested using chi-square tests, and P < 0.05 was regarded as significant. Bivariate analysis was conducted to estimate stillbirth risk. Prevalence ratios (PR) with their 95% confidence intervals (CI) for each predictor were reported.
In total, 101,852 childbirths comprised the SIP database. For this analysis, we included 99,712 childbirths. There were 762 stillbirths during the study period; the Stillbirth ratio of 7.7/1,000 live births (ranged from 3.8 to 18.2/1,000 live births across the different maternities); 586 (76.9%) were antepartum stillbirths, 150 (19.7%) were intrapartum stillbirths and 26 (3.4%) with an ignored time of death. Stillbirth was significantly associated with women with diabetes (PRadj 2.36; 95%CI [1.25-4.46]), preeclampsia (PRadj 2.01; 95%CI [1.26-3.19]), maternal age (PRadj 1.04; 95%CI [1.02-1.05]), any medical condition (PRadj 1.48; 95%CI [1.24-1.76, and severe maternal outcome (PRadj 3.27; 95%CI [3.27-11.66]).
Pregnancy complications and maternal morbidity were significantly associated with stillbirths. The stillbirth ratios varied across the maternity hospitals, which highlights the importance for individual surveillance. Specialized antenatal and intrapartum care remains a priority, particularly for women who are at a higher risk of stillbirth.</description><subject>Births</subject><subject>Bivariate analysis</subject><subject>Diabetes mellitus</subject><subject>Diagnosis</subject><subject>Distribution</subject><subject>Electronics</subject><subject>Evaluation</subject><subject>Female</subject><subject>Health care facilities</subject><subject>Hospital facilities</subject><subject>Humans</subject><subject>Information systems</subject><subject>Latin America - epidemiology</subject><subject>Maternal mortality</subject><subject>Morbidity</subject><subject>Pre-eclampsia</subject><subject>Pregnancy</subject><subject>Pregnancy complications</subject><subject>Public health administration</subject><subject>Resource-Limited Settings</subject><subject>Risk Factors</subject><subject>Still-birth</subject><subject>Stillbirth</subject><subject>Stillbirth - epidemiology</subject><subject>Surveillance 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burden of stillbirths in low resource settings in Latin America: Evidence from a network using an electronic surveillance system</title><author>de Mucio, Bremen ; Sosa, Claudio ; Colomar, Mercedes ; Mainero, Luis ; Cruz, Carmen M ; Chévez, Luz M ; Lopez, Rita ; Carrillo, Gema ; Rizo, Ulises ; Saint Hillaire, Erika E ; Arriaga, William E ; Guadalupe Flores, Rosa M ; Ochoa, Carlos ; Gonzalez, Freddy ; Castro, Rigoberto ; Stefan, Allan ; Moreno, Amanda ; Metelus, Sherly ; Souza, Renato T ; Costa, Maria L ; Luz, Adriana G ; Sousa, Maria H ; Cecatti, José G ; Serruya, Suzanne J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c586t-7393eae457b26cc9a4785685d8e122ec4845cd6765f04dc64f5a25e8cb1d4ae33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Births</topic><topic>Bivariate analysis</topic><topic>Diabetes 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Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de Mucio, Bremen</au><au>Sosa, Claudio</au><au>Colomar, Mercedes</au><au>Mainero, Luis</au><au>Cruz, Carmen M</au><au>Chévez, Luz M</au><au>Lopez, Rita</au><au>Carrillo, Gema</au><au>Rizo, Ulises</au><au>Saint Hillaire, Erika E</au><au>Arriaga, William E</au><au>Guadalupe Flores, Rosa M</au><au>Ochoa, Carlos</au><au>Gonzalez, Freddy</au><au>Castro, Rigoberto</au><au>Stefan, Allan</au><au>Moreno, Amanda</au><au>Metelus, Sherly</au><au>Souza, Renato T</au><au>Costa, Maria L</au><au>Luz, Adriana G</au><au>Sousa, Maria H</au><au>Cecatti, José G</au><au>Serruya, Suzanne J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The burden of stillbirths in low resource settings in Latin America: Evidence from a network using an electronic surveillance system</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2023-12-22</date><risdate>2023</risdate><volume>18</volume><issue>12</issue><spage>e0296002</spage><epage>e0296002</epage><pages>e0296002-e0296002</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>To determine stillbirth ratio and its association with maternal, perinatal, and delivery characteristics, as well as geographic differences in Latin American countries (LAC).
We analysed data from the Perinatal Information System of the Latin American Center for Perinatology and Human Development (CLAP) between January 2018 and June 2021 in 8 health facilities from five LAC countries (Bolivia, Guatemala, Honduras, Nicaragua, and the Dominican Republic). Maternal, pregnancy, and delivery characteristics, in addition to pregnancy outcomes were reported. Estimates of association were tested using chi-square tests, and P < 0.05 was regarded as significant. Bivariate analysis was conducted to estimate stillbirth risk. Prevalence ratios (PR) with their 95% confidence intervals (CI) for each predictor were reported.
In total, 101,852 childbirths comprised the SIP database. For this analysis, we included 99,712 childbirths. There were 762 stillbirths during the study period; the Stillbirth ratio of 7.7/1,000 live births (ranged from 3.8 to 18.2/1,000 live births across the different maternities); 586 (76.9%) were antepartum stillbirths, 150 (19.7%) were intrapartum stillbirths and 26 (3.4%) with an ignored time of death. Stillbirth was significantly associated with women with diabetes (PRadj 2.36; 95%CI [1.25-4.46]), preeclampsia (PRadj 2.01; 95%CI [1.26-3.19]), maternal age (PRadj 1.04; 95%CI [1.02-1.05]), any medical condition (PRadj 1.48; 95%CI [1.24-1.76, and severe maternal outcome (PRadj 3.27; 95%CI [3.27-11.66]).
Pregnancy complications and maternal morbidity were significantly associated with stillbirths. The stillbirth ratios varied across the maternity hospitals, which highlights the importance for individual surveillance. Specialized antenatal and intrapartum care remains a priority, particularly for women who are at a higher risk of stillbirth.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>38134193</pmid><doi>10.1371/journal.pone.0296002</doi><orcidid>https://orcid.org/0000-0001-6050-273X</orcidid><orcidid>https://orcid.org/0000-0003-1371-4558</orcidid><orcidid>https://orcid.org/0000-0003-0662-9742</orcidid><orcidid>https://orcid.org/0000-0001-7445-306X</orcidid><orcidid>https://orcid.org/0000-0003-1285-8445</orcidid><orcidid>https://orcid.org/0000-0001-9863-9993</orcidid><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1932-6203 |
ispartof | PloS one, 2023-12, Vol.18 (12), p.e0296002-e0296002 |
issn | 1932-6203 1932-6203 |
language | eng |
recordid | cdi_plos_journals_3072932013 |
source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
subjects | Births Bivariate analysis Diabetes mellitus Diagnosis Distribution Electronics Evaluation Female Health care facilities Hospital facilities Humans Information systems Latin America - epidemiology Maternal mortality Morbidity Pre-eclampsia Pregnancy Pregnancy complications Public health administration Resource-Limited Settings Risk Factors Still-birth Stillbirth Stillbirth - epidemiology Surveillance systems Womens health |
title | The burden of stillbirths in low resource settings in Latin America: Evidence from a network using an electronic surveillance system |
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