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. 2024 Nov 21;19(11):e0314096.
doi: 10.1371/journal.pone.0314096. eCollection 2024.

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

Meklit Melaku Bezie  1 , Hiwot Altaye Asebe  2 , Angwach Abrham Asnake  3 , Bezawit Melak Fente  4 , Yohannes Mekuria Negussie  5 , Zufan Alamrie Asmare  6 , Mamaru Melkam  7 , Beminate Lemma Seifu  2
Affiliations

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

Meklit Melaku Bezie et al. PLoS One. .

Abstract

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.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Perinatal mortality rate across countries in SSA.
See this image and copyright information in PMC

References

    1. Organization WH: Neonatal and perinatal mortality: country, regional and global estimates: World Health Organization; 2006.
    1. Berhan Y, Berhan A: Perinatal mortality trends in Ethiopia. Ethiopian journal of health sciences 2014, 24:29–40. doi: 10.4314/ejhs.v24i0.4s - DOI - PMC - PubMed
    1. Organization WH: Every newborn: an action plan to end preventable deaths. 2014.
    1. Hug L, Mishra A, Lee S, You D, Moran A, Strong KL, et al.: A neglected tragedy the global burden of stillbirths: report of the UN inter-agency group for child mortality estimation, 2020. In.: United Nations Children’s Fund; 2020.
    1. Hussain S: Neonatal morbidity and mortality pattern in a tertiary care neonatal unit of a teaching hospital. Ann Pak Inst Med Sci 2014, 10(1):7–11.

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