Perinatal mortality associated with use of uterotonics outside of Comprehensive Emergency Obstetric and Neonatal Care: a cross-sectional study

Louise T. Day, Daniel Hruschka, Felicity Mussell, Eva Jeffers, Stacy L. Saha, Shafiul Alam

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Background: Prior studies have shown that using uterotonics to augment or induce labor before arrival at comprehensive Emergency Obstetric and Neonatal Care (CEmONC) settings (henceforth, “outside uterotonics”) may contribute to perinatal mortality in low- and middle-income countries. We estimate its effect on perinatal mortality in rural Bangladesh. Methods: Using hospital records (23986 singleton term births, Jan 1, 2009-Dec 31, 2015) from rural Bangladesh, we use a logistic regression model to estimate the increased risk of perinatal death from uterotonics administered outside a CEmONC facility. Results: Among term births (≥37 weeks gestation), the risk of perinatal death adjusted for key confounders is significantly increased among women reporting uterotonic use outside of CEmONC (OR = 3 · 0, 95 % CI = 2 · 4,3 · 7). This increased risk is particularly high for fresh stillbirths (OR = 4 · 0, 95 % CI = 3 · 0,5 · 3) and intrapartum-related causes of early neonatal deaths (birth asphyxia) (OR = 3 · 1, 95 % CI = 2 · 2,4 · 5). Conclusions: In this sample, outside uterotonic use was associated with substantially increased risk of fresh stillbirths, deaths due to birth asphyxia, and all perinatal deaths. In settings of high uterotonic use outside of controlled settings, substantial improvement in both stillbirth and early neonatal mortality may be made by reducing such use.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalReproductive Health
Volume13
Issue number1
DOIs
StatePublished - Oct 6 2016

Keywords

  • Bangladesh
  • Child survival
  • Neonatal death
  • Perinatal mortality
  • Stillbirth
  • Under-five mortality
  • Uterotonics

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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