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. 2017 May 17;7(5):e013644.
doi: 10.1136/bmjopen-2016-013644.

Understanding determinants of unequal distribution of stillbirth in Tehran, Iran: a concentration index decomposition approach

Amir Almasi-Hashiani  1 , Mahdi Sepidarkish  1 , Saeid Safiri  2 , Esmaeil Khedmati Morasae  3 , Yahya Shadi  4 , Reza Omani-Samani  1
Affiliations

Understanding determinants of unequal distribution of stillbirth in Tehran, Iran: a concentration index decomposition approach

Amir Almasi-Hashiani et al. BMJ Open. .

Abstract

Objective: The present inquiry set to determine the economic inequality in history of stillbirth and understanding determinants of unequal distribution of stillbirth in Tehran, Iran.

Methods: A population-based cross-sectional study was conducted on 5170 pregnancies in Tehran, Iran, since 2015. Principal component analysis (PCA) was applied to measure the asset-based economic status. Concentration index was used to measure socioeconomic inequality in stillbirth and then decomposed into its determinants.

Results: The concentration index and its 95% CI for stillbirth was -0.121 (-0.235 to -0.002). Decomposition of the concentration index showed that mother's education (50%), mother's occupation (30%), economic status (26%) and father's age (12%) had the highest positive contributions to measured inequality in stillbirth history in Tehran. Mother's age (17%) had the highest negative contribution to inequality.

Conclusions: Stillbirth is unequally distributed among Iranian women and is mostly concentrated among low economic status people. Mother-related factors had the highest positive and negative contributions to inequality, highlighting specific interventions for mothers to redress inequality.

Keywords: Tehran; concentration index; decomposition; socioeconomic inequality; stillbirth.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Concentration curve of stillbirth history in Tehran in 2014. Concentration index is the area between equality line and concentration curve that in the present study equalled: −0.121.
See this image and copyright information in PMC

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