Halim, Abdul, Aminu, Mamuda, Dewez, Juan Emmanuel, Biswas, Animesh, Rahman, AKM Fazlur and van den Broek, Nynke 
ORCID: 0000-0001-8523-2684
(2018)
Stillbirth surveillance and review in rural districts in Bangladesh.
BMC PREGNANCY AND CHILDBIRTH, 18 (1).
224-.
Abstract
<h4>Background</h4>An estimated 2.6 million stillbirths occur every year, with the majority occurring in low- and middle-income countries. Understanding the cause of and factors associated with stillbirth is important to help inform the design and implementation of interventions aimed at reducing preventable stillbirths.<h4>Methods</h4>Population-based surveillance with identification of all stillbirths that occurred either at home or in a health facility was introduced in four districts in Bangladesh. Verbal autopsy was conducted for every fifth stillbirth using a structured questionnaire. A hierarchical model was used to assign likely cause of stillbirth.<h4>Results</h4>Six thousand three hundred thirty-three stillbirths were identified for which 1327 verbal autopsies were conducted. 63.9% were intrapartum stillbirths. The population-based stillbirth rate obtained was 20.4 per 1000 births; 53.9% of all stillbirths occurred at home. 69.6% of mothers had accessed health care in the period leading up to the stillbirth. 48.1% had received care from a highly trained healthcare provider. The three most frequent causes of stillbirth were maternal hypertension or eclampsia (15.2%), antepartum haemorrhage (13.7%) and maternal infections (8.9%). Up to 11.3% of intrapartum stillbirths were caused by hypoxia. However, it was not possible to identify a cause of death with reasonable certainty using information obtained via verbal autopsy in 51.9% of stillbirths.<h4>Conclusions</h4>Introducing surveillance for stillbirths at community level is possible. However, verbal autopsy yields limited data, and the questionnaire used for this needs to be revised and/or combined with information obtained through case note review. Most women accessed and received care from a qualified healthcare provider. To reduce the number of preventable stillbirths, the quality of antenatal and intrapartum care needs to be improved.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Stillbirth, Surveillance, Cause of death, Care seeking, Verbal autopsy, Bangladesh |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 14 Feb 2019 10:53 |
| Last Modified: | 19 Jan 2023 01:03 |
| DOI: | 10.1186/s12884-018-1866-2 |
| Open Access URL: | http://doi.org/10.1186/s12884-018-1866-2 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3032837 |
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