Fetal death and its association with indicators of social inequality: 20-year analysis in Tacna, Peru.
<h4>Objective</h4>The aim of this study was to evaluate the rates of fetal mortality in a Peruvian hospital between 2001 and 2020 and to investigate the association of indicators of social inequality (such as access to prenatal care and education) with fetal mortality.<h4>Methodolo...
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| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0292183&type=printable |
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| author | Cesar Copaja-Corzo Sujey Gomez-Colque Jennifer Vilchez-Cornejo Miguel Hueda-Zavaleta Alvaro Taype-Rondan |
| author_facet | Cesar Copaja-Corzo Sujey Gomez-Colque Jennifer Vilchez-Cornejo Miguel Hueda-Zavaleta Alvaro Taype-Rondan |
| author_sort | Cesar Copaja-Corzo |
| collection | DOAJ |
| description | <h4>Objective</h4>The aim of this study was to evaluate the rates of fetal mortality in a Peruvian hospital between 2001 and 2020 and to investigate the association of indicators of social inequality (such as access to prenatal care and education) with fetal mortality.<h4>Methodology</h4>We conducted a retrospective cohort study, including all pregnant women who attended a Peruvian hospital between 2001 and 2020. We collected data from the hospital's perinatal computer system. We used Poisson regression models with robust variance to assess the associations of interest, estimating adjusted relative risks (aRR) and their 95% confidence intervals (95% CI).<h4>Results</h4>We analyzed data from 67,908 pregnant women (median age: 26, range: 21 to 31 years). Of these, 58.3% had one or more comorbidities; the most frequent comorbidities were anemia (33.3%) and urinary tract infection (26.3%). The fetal mortality ratio during the study period was 0.96%, with the highest rate in 2003 (13.7 per 1,000 births) and the lowest in 2016 (6.1 per 1,000 births), without showing a marked trend. Having less than six (aRR: 4.87; 95% CI: 3.99-5.93) or no (aRR: 7.79; 6.31-9.61) prenatal care was associated with higher fetal mortality compared to having six or more check-ups. On the other hand, higher levels of education, such as secondary education (aRR: 0.73; 0.59-0.91), technical college (aRR: 0.63; 0.46-0.85), or university education (aRR: 0.38; 0.25-0.57) were associated with a lower risk of fetal death compared to having primary education or no education. In addition, a more recent year of delivery was associated with lower fetal mortality.<h4>Conclusion</h4>Our study presents findings of fetal mortality rates that are comparable to those observed in Peru in 2015, but higher than the estimated rates for other Latin American countries. A more recent year of delivery was associated with lower fetal mortality, probably due to reduced illiteracy and increased access to health care between 2000 and 2015. The findings suggest a significant association between indicators of social inequality (such as access to prenatal care and education) with fetal mortality. These results emphasize the critical need to address the social and structural determinants of health, as well as to mitigate health inequities, to effectively reduce fetal mortality. |
| first_indexed | 2024-03-11T12:49:47Z |
| format | Article |
| id | doaj.art-7e91acdf048843b6bf250f9218e37510 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-03-11T12:49:47Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj.art-7e91acdf048843b6bf250f9218e375102023-11-04T05:33:19ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-011810e029218310.1371/journal.pone.0292183Fetal death and its association with indicators of social inequality: 20-year analysis in Tacna, Peru.Cesar Copaja-CorzoSujey Gomez-ColqueJennifer Vilchez-CornejoMiguel Hueda-ZavaletaAlvaro Taype-Rondan<h4>Objective</h4>The aim of this study was to evaluate the rates of fetal mortality in a Peruvian hospital between 2001 and 2020 and to investigate the association of indicators of social inequality (such as access to prenatal care and education) with fetal mortality.<h4>Methodology</h4>We conducted a retrospective cohort study, including all pregnant women who attended a Peruvian hospital between 2001 and 2020. We collected data from the hospital's perinatal computer system. We used Poisson regression models with robust variance to assess the associations of interest, estimating adjusted relative risks (aRR) and their 95% confidence intervals (95% CI).<h4>Results</h4>We analyzed data from 67,908 pregnant women (median age: 26, range: 21 to 31 years). Of these, 58.3% had one or more comorbidities; the most frequent comorbidities were anemia (33.3%) and urinary tract infection (26.3%). The fetal mortality ratio during the study period was 0.96%, with the highest rate in 2003 (13.7 per 1,000 births) and the lowest in 2016 (6.1 per 1,000 births), without showing a marked trend. Having less than six (aRR: 4.87; 95% CI: 3.99-5.93) or no (aRR: 7.79; 6.31-9.61) prenatal care was associated with higher fetal mortality compared to having six or more check-ups. On the other hand, higher levels of education, such as secondary education (aRR: 0.73; 0.59-0.91), technical college (aRR: 0.63; 0.46-0.85), or university education (aRR: 0.38; 0.25-0.57) were associated with a lower risk of fetal death compared to having primary education or no education. In addition, a more recent year of delivery was associated with lower fetal mortality.<h4>Conclusion</h4>Our study presents findings of fetal mortality rates that are comparable to those observed in Peru in 2015, but higher than the estimated rates for other Latin American countries. A more recent year of delivery was associated with lower fetal mortality, probably due to reduced illiteracy and increased access to health care between 2000 and 2015. The findings suggest a significant association between indicators of social inequality (such as access to prenatal care and education) with fetal mortality. These results emphasize the critical need to address the social and structural determinants of health, as well as to mitigate health inequities, to effectively reduce fetal mortality.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0292183&type=printable |
| spellingShingle | Cesar Copaja-Corzo Sujey Gomez-Colque Jennifer Vilchez-Cornejo Miguel Hueda-Zavaleta Alvaro Taype-Rondan Fetal death and its association with indicators of social inequality: 20-year analysis in Tacna, Peru. PLoS ONE |
| title | Fetal death and its association with indicators of social inequality: 20-year analysis in Tacna, Peru. |
| title_full | Fetal death and its association with indicators of social inequality: 20-year analysis in Tacna, Peru. |
| title_fullStr | Fetal death and its association with indicators of social inequality: 20-year analysis in Tacna, Peru. |
| title_full_unstemmed | Fetal death and its association with indicators of social inequality: 20-year analysis in Tacna, Peru. |
| title_short | Fetal death and its association with indicators of social inequality: 20-year analysis in Tacna, Peru. |
| title_sort | fetal death and its association with indicators of social inequality 20 year analysis in tacna peru |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0292183&type=printable |
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