Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Pregnancy Childbirth. 2020 Mar 30;20(1):193. doi: 10.1186/s12884-020-02880-5.
Despite the effort to reduce stillbirth, Ethiopia remains one of the countries with the highest rate in the world. Therefore, this study aimed to analyze the trends of stillbirth among births from reproductive age women over time based on Ethiopian Demographic and Health Surveys (EDHSs).
Secondary data analysis was conducted based on the Ethiopian Demographic Health Surveys (EDHSs) conducted in 2005, 2011 and 2016. A total weighted sample of 12,037, 10,588, and 11,375 in 2005, 2011 and 2016 respectively were included for analysis. Trend and Logistic based decomposition analysis technique was used for analyzing the trends of stillbirth over time and factors contributing to the change in stillbirth rate. STATA 14 was employed for data management and analyses. All analyses presented in this paper were weighted for the sampling probabilities and non-response. Complex sampling procedures were also considered during testing of statistical significance.
Among women of reproductive age, the stillbirth rate declined from 13.3/1000 births in 2005 to 9.2 per 1000 births in 2016 with the annual rate of reduction of 3.1%. The study found that the stillbirth rate has been declined over time concerning the place of residence, region, antenatal care, education and place of delivery. The decomposition analysis indicated that about 82.3% of the overall change stillbirth rate was due to the difference in women's composition. Particularly, an increase in women's urban place of residence, health facility delivery, and cesarean delivery were significant predictors for the decline in stillbirth rate over the surveys.
The stillbirth rate has been declined over time. More than 3/4th of the decrease in stillbirth rate was due to the difference in characteristics of women over the surveys. The increase in women's urban place of residence, an increase in cesarean delivery and health facility delivery significantly contributed to the decrease in stillbirth rate over time. Public health interventions targeting rural resident women, strengthening emergency obstetric services and health facility delivery would help to maintain the decreasing trend of stillbirth rate in Ethiopia.
尽管各国都在努力降低死产率，但埃塞俄比亚仍是全球死产率最高的国家之一。因此，本研究旨在根据埃塞俄比亚人口与健康调查（EDHS）分析不同时期育龄妇女的死产率趋势。
本研究采用二次数据分析，依据 2005、2011 和 2016 年的埃塞俄比亚人口与健康调查（EDHS）数据。2005 年、2011 年和 2016 年的总加权样本分别为 12037、10588 和 11375 人。采用趋势和基于逻辑斯谛的分解分析技术分析随时间推移的死产率趋势和导致死产率变化的因素。本研究使用 STATA 14 进行数据管理和分析。本文所有分析均针对抽样概率和无应答进行了加权。在检验统计显著性时还考虑了复杂的抽样程序。
在育龄妇女中，死产率从 2005 年的每 1000 例活产 13.3 例降至 2016 年的每 1000 例活产 9.2 例，年下降率为 3.1%。研究发现，随着时间的推移，居住地、地区、产前护理、教育和分娩地点等因素都与死产率的下降有关。分解分析表明，整体死产率变化的约 82.3%归因于妇女构成的差异。特别是，妇女居住地的城市化、医疗机构分娩和剖宫产的增加是调查期间死产率下降的显著预测因素。
随着时间的推移，死产率呈下降趋势。超过四分之三的死产率下降归因于调查期间妇女特征的差异。妇女居住地的城市化、剖宫产和医疗机构分娩的增加显著促进了死产率的下降。针对农村居民妇女的公共卫生干预措施、加强紧急产科服务和医疗机构分娩将有助于维持埃塞俄比亚不断下降的死产率趋势。
