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. 2019 Mar 11;19(1):88.
doi: 10.1186/s12884-019-2234-6.

Factors associated with perinatal mortality in Nepal: evidence from Nepal demographic and health survey 2001-2016

Pramesh Raj Ghimire  1 , Kingsley E Agho  2 , Andre M N Renzaho  3 , Monjura K Nisha  4 , Michael Dibley  4 , Camille Raynes-Greenow  4
Affiliations

Factors associated with perinatal mortality in Nepal: evidence from Nepal demographic and health survey 2001-2016

Pramesh Raj Ghimire et al. BMC Pregnancy Childbirth. .

Abstract

Background: Perinatal mortality is a devastating pregnancy outcome affecting millions of families in many low and middle-income countries including Nepal. This paper examined the more distant factors associated with perinatal mortality in Nepal.

Methods: A sample of 23,335 pregnancies > 28 weeks' gestation from the Nepal Demographic and Health Survey datasets for the period (2001-2016) was analysed. Perinatal Mortality (PM) is defined as the sum of stillbirth (fetal deaths in pregnancies > 28 weeks' gestation) and early neonatal mortality (deaths within the first week of life), while Extended Perinatal Mortality (EPM) is denoted as the sum of stillbirth and neonatal mortality (deaths within the first 28 days of life). Rates of PM and EPM were calculated. Logistic regression generalized linear latent and mixed models (GLLAMM) that adjusted for clustering and sampling weight was used to examine the factor associated with perinatal mortality.

Results: Over the study period, the PMR was 42 [95% Confidence Interval (CI): 39, 44] per 1000 births for the five-year before each survey; while corresponding EPMR was 49 (95% CI, 46, 51) per 1000 births. Multivariable analyses revealed that women residing in the mountains, who did not use contraceptives, women aged 15-18 years or 19-24 years, and women having no education were associated with increased PM and EPM. The study also identified households using biomass as cooking fuel, and households who reported unimproved sanitation or open defecation were significantly more likely to experience PM and EPM.

Conclusions: Interventions aimed to improve use of contraceptives, and reduce biomass as a source of cooking fuel are needed to achieve the recommended target of < 12 perinatal deaths per 1000 births by 2030.

Keywords: Extended perinatal mortality; NDHS; Nepal; Perinatal mortality.

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Conflict of interest statement

Ethics approval and consent to participate

This study is a secondary analysis of the NDHS data. The NDHS obtained ethical clearance from the Ethical Review Board of Nepal Health Research Council, Kathmandu and ICF Institutional Review Board, Maryland, USA. Data for this study are free to download and use by completing a request application via online DHS program (https://dhsprogram.com). The first author got permission from online DHS program to use data for this study. All four NDHS received informed consent from all the study participants, and the process for obtaining informed consent is also available from https://www.dhsprogram.com/What-We-Do/Protecting-the-Privacy-of-DHS-Survey-Respondents.cfm.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests. KEA is a member of the editorial board (Associate Editor) of BMC Pregnancy and Childbirth, and does not have any role in the journal review and decision making process for this manuscript.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Framework for factors associated with perinatal mortality in Nepal, adopted from Mosley and Chen analytical framework for the study of child survival in low income countries
Fig. 2
Fig. 2
a Rate and 95% Confidence Interval (CI) of perinatal mortality per 1000 births in NDHS 2001, 2006, 2011, and 2016. b Rate and 95% Confidence Interval (CI) of extended perinatal mortality per 1000 births in NDHS 2001, 2006, 2011, and 2016
See this image and copyright information in PMC

References

    1. World Health Organization . Neonatal and perinatal mortality: country, regional and global estimates. Geneva: WHO; 2006.
    1. Wang H, Bhutta ZA, Coates MM, Coggeshall M, Dandona L, Diallo K, et al. Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1725. doi: 10.1016/S0140-6736(16)31575-6. - DOI - PMC - PubMed
    1. Mason E, McDougall L, Lawn JE, Gupta A, Claeson M, Pillay Y, et al. From evidence to action to deliver a healthy start for the next generation. Lancet. 2014;384:455–467. doi: 10.1016/S0140-6736(14)60750-9. - DOI - PubMed
    1. Bhutta ZA, Das JK, Bahl R, Lawn JE, Salam RA, Paul VK, et al. Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? Lancet. 2014;384:347–370. doi: 10.1016/S0140-6736(14)60792-3. - DOI - PubMed
    1. Fikree FF, Gray RH. Demographic survey of the level and determinants of perinatal mortality in Karachi, Pakistan. Paediatr Perinat Epidemiol. 1996;10:86–96. doi: 10.1111/j.1365-3016.1996.tb00029.x. - DOI - PubMed

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