Stillbirth rate and associated risk factors among 869 750 Latin American hospital births 1982-1986.
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 (less than or equal to 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.
Gadow
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EC
Department of Obstetrics and Gynecology, CEMIC, Buenos Aires, Argentina.
Castilla
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EE
Lopez Camelo
J
J
Queenan
J T
JT
D000293:Adolescent; D000328:Adult; D001724:Birth Weight; D005260:Female; D005313:Fetal Death / Q000453:epidemiology* / Q000209:etiology; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007843:Latin America / Q000453:epidemiology; D008297:Male; D008423:Maternal Age; D008427:Maternal Health Services / Q000191:economics / Q000592:standards; D010298:Parity; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors