Socio-economic predictors of stillbirths in Nepal (2001-2011)

Pramesh Raj Ghimire; Kingsley Emwinyore Agho; Andre Renzaho; Aliki Christou; Monjura Khatun Nisha; Michael Dibley; Camille Raynes-Greenow

doi:10.1371/journal.pone.0181332

Socio-economic predictors of stillbirths in Nepal (2001-2011)

PLoS One. 2017 Jul 13;12(7):e0181332. doi: 10.1371/journal.pone.0181332. eCollection 2017.

Authors

Pramesh Raj Ghimire¹, Kingsley Emwinyore Agho¹, Andre Renzaho², Aliki Christou³, Monjura Khatun Nisha³, Michael Dibley³, Camille Raynes-Greenow³

Affiliations

¹ School of Science and Health, Western Sydney University, Penrith, New South Wales, Australia.
² School of Social Sciences and Psychology, Western Sydney University, Penrith, New South Wales, Australia.
³ Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia.

Abstract

Introduction: Stillbirth has a long-lasting impact on parents and families. This study examined socio-economic predictors associated with stillbirth in Nepal for the year 2001, 2006 and 2011.

Methods: The Nepalese Demographic and Health Survey (NDHS) data for the period (2001-2011) were pooled to estimate socio-economic predictors associated with stillbirths in Nepal using binomial logistic regression while taking clustering and sampling weights into account.

Results: A total of 18,386 pregnancies of at least 28 weeks gestation were identified. Of these pregnancies, 335 stillbirths were reported. Stillbirth increased significantly among women that lived in the hills ecological zones (aRR 1.38, 95% CI 1.02, 1.87) or in the mountains ecological zones (aRR 1.71, 95% CI 1.10, 2.66). Women with no schooling (aRR 1.72, 95% CI 1.10, 2.69), women with primary education (aRR 1.81, 95% CI 1.11, 2.97); open defecation (aRR 1.48, 95% CI 1.00, 2.18), and those whose major occupation was agriculture (aRR 1.80, 95% CI 1.16, 2.78) are more likely to report higher stillbirth.

Conclusions: Low levels of education, ecological zones and open defecation were found to be strong predictors of stillbirth. Access to antenatal care services and skilled birth attendants for women in the mountainous and hilly ecological zones of Nepal is needed to further reduce stillbirth and improved services should also focus on women with low levels of education.

MeSH terms

Adolescent
Adult
Female
Health Services Accessibility / standards
Humans
Infant, Newborn
Maternal Age
Middle Aged
Nepal / epidemiology
Pregnancy
Prenatal Care / standards
Socioeconomic Factors*
Stillbirth / epidemiology*
Young Adult

Grants and funding

CRG was supported by National Health and Medical Research Council (of Australia) Career Development Fellowship #1087062, AR is supported by an Australian Research Council Future fellowship FT110100345, AC is supported by an Australian Postgraduate Award funded through the Australian Commonwealth Government, and MKN is supported by Early Career Researcher Postgraduate Scholarship, Sydney Medical School. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.