Identification of factors associated with stillbirth in the Indian state of Bihar using verbal autopsy: A population-based study

作者：Rakhi Dandona, G Anil Kumar, Amit Kumar, Priyanka Singh, Sibin George, Mohammad Akbar, Lalit Dandona · 发表于：PLoS Medicine · 年份：2017 · DOI：10.1371/journal.pmed.1002363 · 被引用次数：60 · 研究领域：Global Maternal and Child Health、Maternal and Perinatal Health Interventions、Autopsy Techniques and Outcomes

BACKGROUND: India was estimated to have the largest numbers of stillbirths globally in 2015, and the Indian government has adopted a target of <10 stillbirths per 1,000 births by 2030 through the India Newborn Action Plan (INAP). The objective of this study was to use verbal autopsy interviews to examine factors associated with stillbirth in the Indian state of Bihar and make recommendations for the INAP to better inform the setting of priorities and actions to reduce stillbirths. METHODS AND FINDINGS: Verbal autopsy interviews were conducted for deaths including stillbirths that occurred from January 2011 to March 2014 in a sample of 109,689 households (87.1% participation) in 1,017 clusters representative of the state of Bihar. The Population Health Metrics Research Consortium shortened verbal autopsy questionnaire was used for each interview, and cause of death was assigned using the SmartVA automated algorithm. A stillbirth was defined as a foetal death with a gestation period of ≥28 weeks wherein the foetus did not show any sign of life. We report on the stillbirth epidemiology and present case studies from the qualitative data on the health provider interface that can be used to improve success of improved, skilled care at birth and delivery interventions. The annualised stillbirth incidence was 21.2 (95% CI 19.7 to 22.6) per 1,000 births, with it being higher in the rural areas. A total of 1,132 stillbirths were identified; 686 (62.2%) were boys, 327 (29.7%) were first...