title: Epidemiology of stillbirth in low-middle income countries: a Global Network Study.
abstract: OBJECTIVE
  To determine population-based stillbirth rates and to determine whether the timing and maturity of the stillbirths suggest a high proportion of potentially preventable deaths.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Communities in six low-income countries (Democratic Republic of Congo, Kenya, Zambia, Guatemala, India, and Pakistan) and one site in a mid-income country (Argentina).
  
  
  METHODS
  Pregnant women residing in the study communities.
  
  
  METHODS
  Over a five-year period, in selected catchment areas, using multiple methodologies, trained study staff obtained pregnancy outcomes on each delivery in their area.
  
  
  METHODS
  Pregnancy outcome, stillbirth characteristics.
  
  
  RESULTS
  Outcomes of 195,400 deliveries were included. Stillbirth rates ranged from 32 per 1,000 in Pakistan to 8 per 1,000 births in Argentina. Three-fourths (76%) of stillbirth offspring were not macerated, 63% were ≥ 37 weeks and 48% weighed 2,500 g or more. Across all sites, women with no education, of high and low parity, of older age, and without access to antenatal care were at significantly greater risk for stillbirth (p<0.001). Compared to those delivered by a physician, women delivered by nurses and traditional birth attendants had a lower risk of stillbirth.
  
  
  CONCLUSIONS
  In these low-middle income countries, most stillbirth offspring were not macerated, were reported as ≥ 37 weeks' gestation, and almost half weighed at least 2,500 g. With access to better medical care, especially in the intrapartum period, many of these stillbirths could likely be prevented.
authors.affiliation: Research Triangle Institute, Durham, NC, USA. mcclure@rti.org
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: McClure
authors.forename: Omrana
authors.initials: O
authors.lastname: Pasha
authors.forename: Shivaprasad S
authors.initials: SS
authors.lastname: Goudar
authors.forename: Elwyn
authors.initials: E
authors.lastname: Chomba
authors.forename: Ana
authors.initials: A
authors.lastname: Garces
authors.forename: Antoinette
authors.initials: A
authors.lastname: Tshefu
authors.forename: Fernando
authors.initials: F
authors.lastname: Althabe
authors.forename: Fabian
authors.initials: F
authors.lastname: Esamai
authors.forename: Archana
authors.initials: A
authors.lastname: Patel
authors.forename: Linda L
authors.initials: LL
authors.lastname: Wright
authors.forename: Janet
authors.initials: J
authors.lastname: Moore
authors.forename: Bhalchandra S
authors.initials: BS
authors.lastname: Kodkany
authors.forename: Jose M
authors.initials: JM
authors.lastname: Belizan
authors.forename: Sarah
authors.initials: S
authors.lastname: Saleem
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Derman
authors.forename: Waldemar A
authors.initials: WA
authors.lastname: Carlo
authors.forename: K Michael
authors.initials: KM
authors.lastname: Hambidge
authors.forename: Pierre
authors.initials: P
authors.lastname: Buekens
authors.forename: Edward A
authors.initials: EA
authors.lastname: Liechty
authors.forename: Carl
authors.initials: C
authors.lastname: Bose
authors.forename: Marion
authors.initials: M
authors.lastname: Koso-Thomas
authors.forename: Alan H
authors.initials: AH
authors.lastname: Jobe
authors.forename: Robert L
authors.initials: RL
authors.lastname: Goldenberg
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D003906:Developing Countries; D005260:Female; D006801:Humans; D007182:Income; D008423:Maternal Age; D008880:Midwifery / Q000706:statistics & numerical data; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data; D011446:Prospective Studies; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology*; D055815:Young Adult