Factors associated with perinatal mortality in sub-Saharan Africa: A multilevel analysis.

Autor: Bezie MM; Department of Public Health, Institute of Public Health, College of Medicine and Health Sciences and Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia., Asebe HA; Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia., Asnake AA; Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wolaita Sodo University, Wolaita Sodo, Ethiopia., Fente BM; Department of General Midwifery, School of Midwifery, College of Medicine & Health Sciences, University of Gondar, Gondar, Ethiopia., Negussie YM; Department of Medicine, Adama General Hospital and Medical College, Adama, Ethiopia., Asmare ZA; Department of Ophthalmology, School of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia., Melkam M; Department of Psychiatry, University of Gondar College of Medicine and Health Science, Gondar, Ethiopia., Seifu BL; Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2024 Nov 21; Vol. 19 (11), pp. e0314096. Date of Electronic Publication: 2024 Nov 21 (Print Publication: 2024).
DOI: 10.1371/journal.pone.0314096
Abstrakt: Background: Perinatal mortality is a major global public health concern, especially in sub-Saharan Africa (SSA). Despite perinatal mortality being a major public health concern in SSA, there are very limited studies on the incidence and factors associated with perinatal mortality. Therefore, we aimed to investigate the factors associated with perinatal mortality in SSA.
Methods: A secondary data analysis was conducted based on the Demographic and Health Survey (DHS) data of 27 SSA countries. About 314,099 births in the preceding five years of the surveys were considered for the analysis. A multilevel binary logistic regression model was fitted to identify factors associated with perinatal mortality. Deviance (-2Log-Likelihood Ratio (LLR)) was used for model comparison. The Adjusted Odds Ratio (AOR) with the 5% Confidence Interval (CI) of the best-fitted model was used to verify the significant association between factors and perinatal mortality.
Results: The perinatal mortality rate in sub-Saharan Africa (SSA) was 37.31 per 1,000 births (95% CI: 36.65, 37.98). In the final best-fit model, factors significantly associated with higher perinatal mortality included media exposure (AOR: 1.12, 95% CI: 1.08, 1.17), maternal age ≥ 35 years (AOR: 1.13, 95% CI: 1.06, 1.21), health facility delivery (AOR: 1.10, 95% CI: 1.06, 1.15), having 2-4 births (AOR: 1.35, 95% CI: 1.25, 1.47), five or more births (AOR: 1.69, 95% CI: 1.53, 1.86), residence in West Africa (AOR: 1.30, 95% CI: 1.24, 1.36) or Central Africa (AOR: 1.05, 95% CI: 1.00, 1.11), rural residency (AOR: 1.08, 95% CI: 1.02, 1.13), and difficulty accessing a health facility (AOR: 1.06, 95% CI: 1.02, 1.10). In contrast, factors significantly associated with lower perinatal mortality were a preceding birth interval of 2-4 years (AOR: 0.70, 95% CI: 0.67, 0.74) or five or more years (AOR: 0.91, 95% CI: 0.84, 0.97), Antenatal Care (ANC) visit (AOR: 0.66, 95% CI: 0.63, 0.69), higher education levels (AOR: 0.82, 95% CI: 0.73, 0.93), middle household wealth (AOR: 0.93, 95% CI: 0.88, 0.98), and richer household wealth (AOR: 0.93, 95% CI: 0.87, 0.99).
Conclusion: Perinatal mortality was a major public health problem in SSA. Maternal socio-demographic, obstetrical, and healthcare-related factors are significantly associated with perinatal mortality. The findings of this study highlighted the need for holistic healthcare interventions targeting enhancing maternal healthcare services to reduce the incidence of perinatal mortality.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright: © 2024 Bezie et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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