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

Abstract

BackgroundPrior 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.MethodsUsing 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.ResultsAmong 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).ConclusionsIn 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12978-016-0241-x) contains supplementary material, which is available to authorized users.

Perinatal Asphyxia and Its Associated Factors among Live Births in the Public Health Facilities of Bahir Dar City, Northwest Ethiopia, 2021

“…For those mothers who gave birth by the administration of uterotonic drug, their newborns were 2.8 times more likely to be asphyxiated. This finding was agreed with studies done in India and Bangladesh [ 23 , 32 , 48 ]. This might be because uterotonics can cause hyperstimulation (tachysystole) and decrease blood flow to the fetus through the placenta [ 47 ].…”

Logistical, cultural, and structural barriers to immediate neonatal care and neonatal resuscitation in Bihar, India

“…Addressing this and the perceived value of an infant’s life compared to that of the mother, particularly when obstetric and neonatal complications occur simultaneously, requires further research to better understand local values. Nonetheless, inappropriate administration of oxytocin, which has been proven to increase the risk of perinatal death in rural Bangladesh [ 35 ], and late maternal presentation to PHCs, which prevents fetal monitoring that has been identified as a key determinant of resuscitations in Tanzania [ 28 ], may be more easily addressed with birth planning during antenatal time.…”

From Pre-Implementation to Institutionalization: Lessons From Sustaining a Perinatal Audit Program in South Africa

“…7 The PPIP tool has also been adapted and used in other settings outside of South Africa. [68][69][70] Box 3 provides 10 lessons from this research, which may help South Africa and other countries in their efforts to introduce, expand, and sustain perinatal audit. These lessons relate to findings from other studies examining the history of implementation of MPDSR processes.…”