The burden of stillbirths in low resource settings in Latin America: Evidence from a network using an electronic surveillance system.

<h4>Objective</h4>To determine stillbirth ratio and its association with maternal, perinatal, and delivery characteristics, as well as geographic differences in Latin American countries (LAC).<h4>Methods</h4>We analysed data from the Perinatal Information System of the Latin...

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Main Authors: Bremen de Mucio, Claudio Sosa, Mercedes Colomar, Luis Mainero, Carmen M Cruz, Luz M Chévez, Rita Lopez, Gema Carrillo, Ulises Rizo, Erika E Saint Hillaire, William E Arriaga, Rosa M Guadalupe Flores, Carlos Ochoa, Freddy Gonzalez, Rigoberto Castro, Allan Stefan, Amanda Moreno, Sherly Metelus, Renato T Souza, Maria L Costa, Adriana G Luz, Maria H Sousa, José G Cecatti, Suzanne J Serruya
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0296002
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author Bremen de Mucio
Claudio Sosa
Mercedes Colomar
Luis Mainero
Carmen M Cruz
Luz M Chévez
Rita Lopez
Gema Carrillo
Ulises Rizo
Erika E Saint Hillaire
William E Arriaga
Rosa M Guadalupe Flores
Carlos Ochoa
Freddy Gonzalez
Rigoberto Castro
Allan Stefan
Amanda Moreno
Sherly Metelus
Renato T Souza
Maria L Costa
Adriana G Luz
Maria H Sousa
José G Cecatti
Suzanne J Serruya
author_facet Bremen de Mucio
Claudio Sosa
Mercedes Colomar
Luis Mainero
Carmen M Cruz
Luz M Chévez
Rita Lopez
Gema Carrillo
Ulises Rizo
Erika E Saint Hillaire
William E Arriaga
Rosa M Guadalupe Flores
Carlos Ochoa
Freddy Gonzalez
Rigoberto Castro
Allan Stefan
Amanda Moreno
Sherly Metelus
Renato T Souza
Maria L Costa
Adriana G Luz
Maria H Sousa
José G Cecatti
Suzanne J Serruya
author_sort Bremen de Mucio
collection DOAJ
description <h4>Objective</h4>To determine stillbirth ratio and its association with maternal, perinatal, and delivery characteristics, as well as geographic differences in Latin American countries (LAC).<h4>Methods</h4>We analysed data from the Perinatal Information System of the Latin American Center for Perinatology and Human Development (CLAP) between January 2018 and June 2021 in 8 health facilities from five LAC countries (Bolivia, Guatemala, Honduras, Nicaragua, and the Dominican Republic). Maternal, pregnancy, and delivery characteristics, in addition to pregnancy outcomes were reported. Estimates of association were tested using chi-square tests, and P < 0.05 was regarded as significant. Bivariate analysis was conducted to estimate stillbirth risk. Prevalence ratios (PR) with their 95% confidence intervals (CI) for each predictor were reported.<h4>Results</h4>In total, 101,852 childbirths comprised the SIP database. For this analysis, we included 99,712 childbirths. There were 762 stillbirths during the study period; the Stillbirth ratio of 7.7/1,000 live births (ranged from 3.8 to 18.2/1,000 live births across the different maternities); 586 (76.9%) were antepartum stillbirths, 150 (19.7%) were intrapartum stillbirths and 26 (3.4%) with an ignored time of death. Stillbirth was significantly associated with women with diabetes (PRadj 2.36; 95%CI [1.25-4.46]), preeclampsia (PRadj 2.01; 95%CI [1.26-3.19]), maternal age (PRadj 1.04; 95%CI [1.02-1.05]), any medical condition (PRadj 1.48; 95%CI [1.24-1.76, and severe maternal outcome (PRadj 3.27; 95%CI [3.27-11.66]).<h4>Conclusions</h4>Pregnancy complications and maternal morbidity were significantly associated with stillbirths. The stillbirth ratios varied across the maternity hospitals, which highlights the importance for individual surveillance. Specialized antenatal and intrapartum care remains a priority, particularly for women who are at a higher risk of stillbirth.
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spelling doaj-art-c62640c465e445d28906dba485647f112025-08-20T02:23:15ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-011812e029600210.1371/journal.pone.0296002The burden of stillbirths in low resource settings in Latin America: Evidence from a network using an electronic surveillance system.Bremen de MucioClaudio SosaMercedes ColomarLuis MaineroCarmen M CruzLuz M ChévezRita LopezGema CarrilloUlises RizoErika E Saint HillaireWilliam E ArriagaRosa M Guadalupe FloresCarlos OchoaFreddy GonzalezRigoberto CastroAllan StefanAmanda MorenoSherly MetelusRenato T SouzaMaria L CostaAdriana G LuzMaria H SousaJosé G CecattiSuzanne J Serruya<h4>Objective</h4>To determine stillbirth ratio and its association with maternal, perinatal, and delivery characteristics, as well as geographic differences in Latin American countries (LAC).<h4>Methods</h4>We analysed data from the Perinatal Information System of the Latin American Center for Perinatology and Human Development (CLAP) between January 2018 and June 2021 in 8 health facilities from five LAC countries (Bolivia, Guatemala, Honduras, Nicaragua, and the Dominican Republic). Maternal, pregnancy, and delivery characteristics, in addition to pregnancy outcomes were reported. Estimates of association were tested using chi-square tests, and P < 0.05 was regarded as significant. Bivariate analysis was conducted to estimate stillbirth risk. Prevalence ratios (PR) with their 95% confidence intervals (CI) for each predictor were reported.<h4>Results</h4>In total, 101,852 childbirths comprised the SIP database. For this analysis, we included 99,712 childbirths. There were 762 stillbirths during the study period; the Stillbirth ratio of 7.7/1,000 live births (ranged from 3.8 to 18.2/1,000 live births across the different maternities); 586 (76.9%) were antepartum stillbirths, 150 (19.7%) were intrapartum stillbirths and 26 (3.4%) with an ignored time of death. Stillbirth was significantly associated with women with diabetes (PRadj 2.36; 95%CI [1.25-4.46]), preeclampsia (PRadj 2.01; 95%CI [1.26-3.19]), maternal age (PRadj 1.04; 95%CI [1.02-1.05]), any medical condition (PRadj 1.48; 95%CI [1.24-1.76, and severe maternal outcome (PRadj 3.27; 95%CI [3.27-11.66]).<h4>Conclusions</h4>Pregnancy complications and maternal morbidity were significantly associated with stillbirths. The stillbirth ratios varied across the maternity hospitals, which highlights the importance for individual surveillance. Specialized antenatal and intrapartum care remains a priority, particularly for women who are at a higher risk of stillbirth.https://doi.org/10.1371/journal.pone.0296002
spellingShingle Bremen de Mucio
Claudio Sosa
Mercedes Colomar
Luis Mainero
Carmen M Cruz
Luz M Chévez
Rita Lopez
Gema Carrillo
Ulises Rizo
Erika E Saint Hillaire
William E Arriaga
Rosa M Guadalupe Flores
Carlos Ochoa
Freddy Gonzalez
Rigoberto Castro
Allan Stefan
Amanda Moreno
Sherly Metelus
Renato T Souza
Maria L Costa
Adriana G Luz
Maria H Sousa
José G Cecatti
Suzanne J Serruya
The burden of stillbirths in low resource settings in Latin America: Evidence from a network using an electronic surveillance system.
PLoS ONE
title The burden of stillbirths in low resource settings in Latin America: Evidence from a network using an electronic surveillance system.
title_full The burden of stillbirths in low resource settings in Latin America: Evidence from a network using an electronic surveillance system.
title_fullStr The burden of stillbirths in low resource settings in Latin America: Evidence from a network using an electronic surveillance system.
title_full_unstemmed The burden of stillbirths in low resource settings in Latin America: Evidence from a network using an electronic surveillance system.
title_short The burden of stillbirths in low resource settings in Latin America: Evidence from a network using an electronic surveillance system.
title_sort burden of stillbirths in low resource settings in latin america evidence from a network using an electronic surveillance system
url https://doi.org/10.1371/journal.pone.0296002
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