IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0039050.html
   My bibliography  Save this article

Effect of Socioeconomic Deprivation and Health Service Utilisation on Antepartum and Intrapartum Stillbirth: Population Cohort Study from Rural Ghana

Author

Listed:
  • Yoonhee P Ha
  • Lisa S Hurt
  • Charlotte Tawiah-Agyemang
  • Betty R Kirkwood
  • Karen M Edmond

Abstract

Background: No studies have examined the effect of socioeconomic deprivation on antepartum and intrapartum stillbirths in the poorest women in low income countries. Methodology/ Principal Findings: This study used data from a prospective population based surveillance system involving all women of childbearing age and their babies in rural Ghana. The primary objective was to evaluate associations between household wealth and risk of antepartum and intrapartum stillbirth. The secondary objective was to assess whether any differences in risk were mediated by utilisation of health services during pregnancy. Data were analysed using multivariable logistic regression. Random effect models adjusted for clustering of women who delivered more than one infant. There were 80267 babies delivered from 1 July 2003 to 30 September 2008: 77666 live births and 2601 stillbirths. Of the stillbirths 1367 (52.6%) were antepartum, 989 (38.0%) were intrapartum and 245 (9.4%) had no data on the timing of death. 94.8% of the babies born in the study (76129/80267) had complete data on all covariates and outcomes. 36 878 (48.4%) of babies were born to women in the two poorest quintiles and 3697 (4.9%) had no pregnancy care. There was no association between wealth and antepartum stillbirths. There was a marked ‘dose response’ of increasing risk of intrapartum stillbirth with increasing levels of socioeconomic deprivation (adjOR 1.09 [1.03–1.16] p value 0.002). Women in the poorest two quintiles had greater risk of intrapartum stillbirth (adjOR 1.19 [1.02–1.38] p value 0.023) compared to the richest women. Adjusting for heath service utilisation and other variables did not alter results. Conclusions/ Significance: Poor women had a high risk of intrapartum stillbirth and this risk was not influenced by health service utilisation. Health system strengthening is required to meet the needs of poor women in our study population.

Suggested Citation

  • Yoonhee P Ha & Lisa S Hurt & Charlotte Tawiah-Agyemang & Betty R Kirkwood & Karen M Edmond, 2012. "Effect of Socioeconomic Deprivation and Health Service Utilisation on Antepartum and Intrapartum Stillbirth: Population Cohort Study from Rural Ghana," PLOS ONE, Public Library of Science, vol. 7(7), pages 1-8, July.
    • Handle: RePEc:plo:pone00:0039050
    DOI: 10.1371/journal.pone.0039050
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0039050
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0039050&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0039050?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0039050. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.