Mustufa Muhammad Ayaz, Kulsoom Shazia, Sameen Ifra, Moorani Khemchand N, Memon Ashfaqe Ahmed, Korejo Razia
Muhammad Ayaz Mustufa, MBE, Ph.D, Senior Research Officer, Pakistan Medical Research Centre, National Institute of Child Health, Karachi, Pakistan.
Shazia Kulsoom, MBBS, FCPS, Assistant Professor, Department of Pediatric Medicine Unit III, National Institute of Child Health, Karachi, Pakistan.
Pak J Med Sci. 2016 Jan-Feb;32(1):91-4. doi: 10.12669/pjms.321.8558.
Pakistan accounts for the highest stillbirth rate in the world. Therefore, this observational study was planned to determine the prevalence of stillbirths and its associated demographic characteristics in the given context. Hence our objective included: To determine the frequency of stillbirths with reference to parity and gestational age in a tertiary care public hospital, Karachi. To determine the socio-demographic characteristics of families with stillbirths.
All pregnant mothers who delivered stillbirth babies at Gynaecology and Obstetrics ward of Jinnah Postgraduate Medical Center, Karachi a tertiary care facility were prospectively enrolled from October 2012 to September 2013. Deliveries occurred before 28 weeks of gestational age were excluded. Gestational age was confirmed from hospital record and attending physicians. Data was collected on predesigned proforma and analyzed using descriptive statistics.
Among 7708 registered deliveries, 137 were stillbirths. A total of 84 mothers were primiparous and 12% of mothers were below 20 years at the time of delivery. Majority of stillbirths were macerated type (80.3%) and 20% were fresh stillbirth. About 55% of still births occurred between 33-37 weeks and 20% between 28-32 weeks. Almost 80% (109) of stillbirths were low birth weight and only 20% (28) were normal birth weight.
This study shows that stillbirths are more common in primiparous mothers in a given context. Conducting awareness sessions with special focus on antenatal and obstetrical care of primiparous may be helpful to reduce still births.
巴基斯坦的死产率位居世界之首。因此，本观察性研究旨在确定特定背景下死产的发生率及其相关人口统计学特征。我们的目标包括：确定卡拉奇一家三级医疗公立医院中，死产发生率与胎次和孕周的关系。确定死产家庭的社会人口学特征。
2012年10月至2013年9月，前瞻性纳入在卡拉奇真纳研究生医学中心妇产科病房分娩死产儿的所有孕妇，该中心为三级医疗机构。排除孕周小于28周的分娩。孕周由医院记录和主治医生确认。通过预先设计的表格收集数据，并使用描述性统计方法进行分析。
在7708例登记分娩中，有137例为死产。共有84名母亲为初产妇，12%的母亲在分娩时年龄小于20岁。大多数死产为浸软型（80.3%），20%为新鲜死产。约55%的死产发生在33 - 37周之间，20%发生在28 - 32周之间。几乎80%（109例）的死产儿出生体重低，只有20%（28例）出生体重正常。
本研究表明，在特定背景下，死产在初产妇中更为常见。开展特别关注初产妇产前和产科护理的宣传活动可能有助于降低死产率。
