Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Oct 6;13(1):129.
doi: 10.1186/s12978-016-0241-x.

Perinatal mortality associated with use of uterotonics outside of Comprehensive Emergency Obstetric and Neonatal Care: a cross-sectional study

Louise T Day  1   2 , Daniel Hruschka  3 , Felicity Mussell  4 , Eva Jeffers  3 , Stacy L Saha  5 , Shafiul Alam  5
Affiliations

Perinatal mortality associated with use of uterotonics outside of Comprehensive Emergency Obstetric and Neonatal Care: a cross-sectional study

Louise T Day et al. Reprod Health. .

Abstract

Background: Prior studies have shown that using uterotonics to augment or induce labor before arrival at comprehensive Emergency Obstetric and Neonatal Care (CEmONC) settings (henceforth, "outside uterotonics") may contribute to perinatal mortality in low- and middle-income countries. We estimate its effect on perinatal mortality in rural Bangladesh.

Methods: Using hospital records (23986 singleton term births, Jan 1, 2009-Dec 31, 2015) from rural Bangladesh, we use a logistic regression model to estimate the increased risk of perinatal death from uterotonics administered outside a CEmONC facility.

Results: Among term births (≥37 weeks gestation), the risk of perinatal death adjusted for key confounders is significantly increased among women reporting uterotonic use outside of CEmONC (OR = 3 · 0, 95 % CI = 2 · 4,3 · 7). This increased risk is particularly high for fresh stillbirths (OR = 4 · 0, 95 % CI = 3 · 0,5 · 3) and intrapartum-related causes of early neonatal deaths (birth asphyxia) (OR = 3 · 1, 95 % CI = 2 · 2,4 · 5).

Conclusions: In this sample, outside uterotonic use was associated with substantially increased risk of fresh stillbirths, deaths due to birth asphyxia, and all perinatal deaths. In settings of high uterotonic use outside of controlled settings, substantial improvement in both stillbirth and early neonatal mortality may be made by reducing such use.

Keywords: Bangladesh; Child survival; Neonatal death; Perinatal mortality; Stillbirth; Under-five mortality; Uterotonics.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Sampling flow diagram
See this image and copyright information in PMC

References

    1. UNICEF. Child_Mortality_Report_2015_Web_8_Sept_15.pdf http://www.unicef.org/publications/files/Child_Mortality_Report_2015_Web.... Accessed 8 Sept 2015.
    1. Blencowe H, Cousens S, Bianchi Jassir F, Say L, Chou D, Colin Mathers C, et al. National, regional, and worldwide estimates of stillbirth rates in 2015 with trends from 2000: a systematic analysis. Lancet Glob Health. 2016;4:e98–108. doi: 10.1016/S2214-109X(15)00275-2. - DOI - PubMed
    1. Lawn JE, Blencowe H, Waisa P, Amouzou A, Mathers C, Hogan D, et al. Stillbirths: rates, risk factors and acceleration towards 2013. Published Online January 18, 2016 http://dx.doi.org/10.1016/ S0140-6736(15)00837-5. - PubMed
    1. Oestergaard MZ, Inoue M, Yoshida S, Mahanani WR, Gore FM, Cousens S, et al. Neonatal mortality levels for 193 countries in 2009 with trends since 1990: a systematic analysis of progress, projections, and priorities. PLoS Med. 2011;8(8):e1001080. doi: 10.1371/journal.pmed.1001080. - DOI - PMC - PubMed
    1. Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. The Lancet. 2014. Epub Sept. 30, 2014. - PubMed

MeSH terms

LinkOut - more resources