TY - JOUR AU - Nisar, Muhammad Imran AU - Ilyas, Muhammad AU - Naeem, Komal AU - Fatima, Urooj AU - Shafiq, yasir AU - Jehan, Fyezah PY - 2017/05/02 Y2 - 2024/03/29 TI - Rates and causes of stillbirth in a demographic surveillance site in Karachi, Pakistan JF - Online Journal of Public Health Informatics JA - OJPHI VL - 9 IS - 1 SE - Surveillance in Low Resource Income Countries DO - 10.5210/ojphi.v9i1.7789 UR - https://ojphi.org/ojs/index.php/ojphi/article/view/7789 SP - AB - <div style="left: 79.8182px; top: 302.208px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.08117);" data-canvas-width="56.563006734006734">Objective</div><div style="left: 93.1212px; top: 315.467px; font-size: 12.564px; font-family: serif; transform: scaleX(1.05692);" data-canvas-width="339.28757979797984">To determine burden, timing and causes of stillbirths in a</div><div style="left: 79.8182px; top: 330.249px; font-size: 12.564px; font-family: serif; transform: scaleX(0.990213);" data-canvas-width="348.65402171717176">prospective cohort of pregnant from a low income community setting</div><div style="left: 79.8182px; top: 345.03px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00054);" data-canvas-width="107.10787037037036">in peri urban Karachi</div><div style="left: 79.8182px; top: 373.157px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.11744);" data-canvas-width="73.28565488215487">Introduction</div><div style="left: 93.1212px; top: 386.417px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01298);" data-canvas-width="338.38548653198643">Stillbirth remained a neglected issue absent from mention in</div><div style="left: 79.8182px; top: 401.198px; font-size: 12.564px; font-family: serif; transform: scaleX(0.995716);" data-canvas-width="348.83243013468007">Millennium Development Goals. An estimated 2.6 million babies are</div><div style="left: 79.8182px; top: 415.979px; font-size: 12.564px; font-family: serif; transform: scaleX(0.995804);" data-canvas-width="348.81358417508403">stillborn every year withhighest rate in Pakistan, 43.1 stillbirths/1000</div><div style="left: 79.8182px; top: 430.76px; font-size: 12.564px; font-family: serif; transform: scaleX(0.97865);" data-canvas-width="348.69297003366995">births. There is lack of good quality prospective population based data</div><div style="left: 79.8182px; top: 445.541px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00121);" data-canvas-width="302.2138080808079">in Pakistanregarding burden, timing and causes of stillbirths</div><div style="left: 79.8182px; top: 473.669px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.0727);" data-canvas-width="51.65049326599326">Methods</div><div style="left: 93.1212px; top: 486.929px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01456);" data-canvas-width="338.3892557239053">From Jan – Dec 2012, Community Helath Workers (CHWs)</div><div style="left: 79.8182px; top: 501.71px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00312);" data-canvas-width="319.6777306397305">identified pregnant women through 3 monthly household visits.</div><div style="left: 93.1212px; top: 516.491px; font-size: 12.564px; font-family: serif; transform: scaleX(0.987747);" data-canvas-width="335.3073131313129">Pregnant women were then followed up till end of their pregnancy.</div><div style="left: 79.8182px; top: 531.272px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03186);" data-canvas-width="349.76718973063976">In case of a stillbirth, a detailed verbal autopsy (VA) interview was</div><div style="left: 79.8182px; top: 546.053px; font-size: 12.564px; font-family: serif; transform: scaleX(0.956313);" data-canvas-width="350.29738939393934">undertaken 2 weeks after the outcome by a research assistant. VA</div><div style="left: 79.8182px; top: 560.834px; font-size: 12.564px; font-family: serif; transform: scaleX(0.992448);" data-canvas-width="348.7130723905722">forms were then reviewed by 2 independent Physicians who assigned</div><div style="left: 79.8182px; top: 575.616px; font-size: 12.564px; font-family: serif; transform: scaleX(0.995108);" data-canvas-width="348.75202070707076">a cause for stillbirth. In case of disagreement, VA form was reviewed</div><div style="left: 79.8182px; top: 590.397px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00606);" data-canvas-width="351.26607171717166">by a third physician. A consensus between two physicians was</div><div style="left: 79.8182px; top: 605.178px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00572);" data-canvas-width="153.8584141414142">required for a definitive cause.</div><div style="left: 79.8182px; top: 633.305px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.08437);" data-canvas-width="45.38107070707071">Results</div><div style="left: 93.1212px; top: 646.565px; font-size: 12.564px; font-family: serif; transform: scaleX(0.95857);" data-canvas-width="336.9531936026937">There were a total of 273 stillbirths (3.04%) reported. Stillbirth</div><div style="left: 79.8182px; top: 661.346px; font-size: 12.564px; font-family: serif; transform: scaleX(0.986728);" data-canvas-width="348.44671616161617">rate was 30.7/1000 births. Distribution of antepartum and intrapartum</div><div style="left: 79.8182px; top: 676.127px; font-size: 12.564px; font-family: serif; transform: scaleX(0.976355);" data-canvas-width="348.60753501683485">stillbirths was 83% and 17%. Three most common causes of stillbirths</div><div style="left: 79.8182px; top: 690.908px; font-size: 12.564px; font-family: serif; transform: scaleX(1.08911);" data-canvas-width="354.214836195286">included pregnancy induced Hypertension(37%), antepartum</div><div style="left: 79.8182px; top: 705.69px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00329);" data-canvas-width="266.5572525252524">hemorrhage (10%) and obstructed labor(6%) (fig. 1).</div><div style="left: 79.8182px; top: 733.817px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.10256);" data-canvas-width="75.39640235690236">Conclusions</div><div style="left: 93.1212px; top: 747.077px; font-size: 12.564px; font-family: serif; transform: scaleX(0.999484);" data-canvas-width="337.80880016835016">We have reported a high burden of stillbirths that take place</div><div style="left: 79.8182px; top: 761.858px; font-size: 12.564px; font-family: serif; transform: scaleX(0.997928);" data-canvas-width="351.15425235690213">during the intrapartum period. This reemphasizes need for good</div><div style="left: 79.8182px; top: 776.639px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03631);" data-canvas-width="349.6867803030303">quality antenatal care in these settings. Appropriate measure needs</div><div style="left: 79.8182px; top: 791.42px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01059);" data-canvas-width="349.3287070707071">to be taken targeting most common causes of stillbirths, focusing on</div><div style="left: 79.8182px; top: 806.201px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0013);" data-canvas-width="212.14268518518526">improved antepartum health care facilities</div> ER -