A META-ANALYSIS OF SOCIO-DEMOGRAPHIC FACTORS FOR PERINATAL MORTALITY IN DEVELOPING COUNTRIES A SUBGROUP ANALYSIS OF THE NATIONAL SURVEYS AND SMALL SCALE STUDIES

Abstract

BACKGROUND: Although the perinatal mortality in low income countries is about five-folds higherthan in the high income countries, little is known about the association of socio-demographic factorswith perinatal mortality. National and small scale studies so far reported have shown very contradictoryresults. The objective of this meta-analysis was to assess the association of perinatal mortality withselected sociodemographic factors.METHODS: A computer based literature search was conducted mainly in the databases of AfricanJournals Online, MEASURE Demographic and Health Survey (DHS), Google Scholar, HINARI,PUBMED, MEDLINE and the Cochrane Library. The inclusion criteria were: 1) studies that assessedthe perinatal mortality in developing countries in relation to socio-demographic predictors and 2) studiespublished in English and conducted after the year 1990. Subgroup meta-analyses of perinatal mortalitywere performed for mothers’ age, residence, educational level and wealth status. Sensitivity analysis andheterogeneity testing were done.RESULTS: In this meta-analysis, several inconsistent associations of perinatal mortality with theselected socio-demographic variables were observed in the primary studies level, both DHS and smallscale studies. However, the overall odds ratio (OR) demonstrated statistically significant association ofperinatal mortality with low maternal age (OR=1.2) and short birth interval (OR=1.4) but was notinfluenced by the mothers’ residence, low educational level and household wealth index. Veryconsistently, the highest perinatal mortality rates reported when the birth intervals were either too short(<15 months) or too long (>39 months).CONCLUSION: Because of the disagreement among previous studies, the present study demonstrated asmall effect size on the increased risk of perinatal mortality among women who were pregnant duringteenage ages and gave birth too frequently or after a long interval. Therefore, to confirm the strongpredictors of perinatal mortality, further studies on sociodemographic factors are needed.