Background
Methods
Study region and population
Study design, protocol and ethical approval
Hospital level | I | II | III | Total |
---|---|---|---|---|
Number of hospitals | 85 | 16 | 6 | |
All births | 17,991 (30.4) | 23,758 (40.1) | 17,441 (29.5) | 59,190 |
Fetal deaths/stillbirths | 9 (0.1) | 78 (0.3) | 80 (0.5) | 167 (0.28) |
Live births | 17,982 (99.9) | 23,680 (99.7) | 17,361 (99.5) | 59,023 (99.7) |
Males* | 9959 (55.4) | 12,278 (51.7) | 9259 (53.1) | 31,496 (53.2) |
Gestational age (weeks)* | 39.3 ± 1.1 | 39.2 ± 1.3 | 38.7 ± 2.0 | 39.1 ± 1.5 |
Birthweight (grams)* | 3480 ± 456 | 3465 ± 476 | 3392 ± 587 | 3448 ± 507 |
Preterm births* | 111 (0.6) | 639 (2.7) | 1654 (9.5) | 2404 (4.06) |
Low birthweight* | 179 (1.0) | 437 (1.8) | 1079 (6.2) | 1695 (2.9) |
Multiple-births* | 101 (0.6) | 426 (1.8) | 723 (4.1) | 1250 (2.1) |
Congenital anomaliesa* | 80 (0.4) | 165 (0.7) | 79 (0.5) | 324 (0.55) |
Cesarean delivery* | 9265 (51.5) | 13,778 (58.0) | 9183 (52.7) | 32,226 (54.4) |
Pregnancy complications* | 2322 (12.9) | 2331 (9.8) | 3675 (21.1) | 8328 (14.1) |
HDP* | 541 (3.0) | 1155 (4.9) | 1224 (7.0) | 2920 (4.9) |
PROM* | 773 (4.3) | 2303 (9.7) | 2191 (12.6) | 5267 (8.9) |
GDM | 62 (0.3) | 112 (0.5) | 730 (4.2) | 904 (1.5) |
Anemia* | 1116 (6.2) | 1096 (4.6) | 2272 (13.0) | 4484 (7.6) |
Antenatal steroids*f | 17 (17.3) | 189 (31.0) | 638 (39.9) | 844 (36.6) |
Maternal age*, years | 26.6 ± 5.0 | 26.8 ± 4.7 | 27.4 ± 4.8 | 26.9 ± 4.8 |
Delayed childbearing* | 1428 (7.9) | 1842 (7.8) | 1646 (9.4) | 4916 (8.3) |
> 9 years’ education* | 1967 (10.9) | 8926 (37.6) | 11,846 (67.9) | 22,739 (38.4) |
Amniotic fluid volume* | ||||
Normal | 15,125 (84.1) | 20,697 (87.1) | 14,539 (83.4) | 50,361 (85.1) |
Polyhydramnios | 1603 (8.9) | 865 (3.6) | 1720 (9.9) | 4188 (7.1) |
Oligohydramnios | 1263 (7.0) | 2196 (9.2) | 1182 (6.8) | 4641 (7.8) |
Amniotic contamination* | ||||
Normal | 15,847 (88.1) | 19,808 (83.4) | 15,416 (88.4) | 51,071 (86.3) |
Grade I | 1080 (6.0) | 1464 (6.2) | 380 (2.2) | 2924 (4.9) |
Grade II | 623 (3.5) | 1214 (5.1) | 385 (2.2) | 2222 (3.8) |
Grade III | 441 (2.5) | 1272 (5.4) | 1260 (7.2) | 2973 (5.0) |
Apgar score | ||||
1-min ≤7* | 181 (1.0) | 533 (2.2) | 857 (4.9) | 1571 (2.7) |
1-min ≤3* | 36 (0.2) | 156 (0.7) | 155 (0.9) | 347 (0.6) |
5-min ≤7* | 68 (0.4) | 199 (0.8) | 287 (1.6) | 554 (0.9) |
5-min ≤3* | 44 (0.2) | 126 (0.5) | 123 (0.7) | 293 (0.5) |
Deaths at deliveryb* | 12 (0.1) | 88 (0.4) | 98 (0.6) | 198 (0.3) |
Hospitalized on day 1* | 0 | 1162 (4.9) | 2103 (12.1) | 3265 (5.7) |
Early neonatal deathsc* | 21 (0.1) | 40 (0.2) | 78 (0.4) | 139 (0.2) |
Late neonatal deathsd* | 6 (0.03) | 10 (0.04) | 25 (0.1) | 41 (0.1) |
All deathse* | 37 (0.2) | 131 (0.6) | 190 (1.1) | 358 (0.6) |
Perinatal mortality*, n (‰) | 30 (1.6) | 118 (5.0) | 158 (9.1) | 306 (5.2) |
Neonatal mortality*, n (‰) | 27 (1.5) | 50 (2.1) | 103 (5.9) | 180 (3.0) |
Definitions of vital statistics and perinatal morbidities
Statistical analysis
Results
Vital statistics
Pregnancy complications
Pregnancy co-morbidities and complications | |||
---|---|---|---|
Yes | No | Total | |
All pregnancies | 8188 (14.0) | 50,374 (86.0) | 58,562 |
Maternal age (years)* | 27.2 ± 5.0 | 26.9 ± 4.8 | 26.9 ± 4.9 |
< 20 | 275 (3.3) | 1695 (3.3) | 1970 (3.3) |
20–24 | 2181 (26.2) | 14,568 (28.6) | 16,749 (28.3) |
25–29 | 3659 (43.9) | 22,613 (44.5) | 26,272 (44.4) |
30–34 | 1391 (16.7) | 7892 (15.5) | 9283 (15.7) |
≥ 35 | 822 (9.9) | 4094 (8.0) | 4916 (8.3) |
Antenatal steroidsf | 203 (33.7) | 641 (37.7) | 844 (1.4) |
First delivery* | 5835 (70.1) | 34,065 (67.0) | 39,900 (67.4) |
Cesarean delivery* | 4786 (57.5) | 27,440 (53.9) | 32,226 (54.4) |
Birth numbers | 8328 (14.1) | 50,862 (85.9) | 59,190 |
Live births | 8294 (99.6) | 50,729 (99.7) | 59,023 (99.7) |
Preterm births* | 621 (7.5) | 1783 (3.5) | 2404 (4.06) |
24–27 weeks | 12 (0.1) | 36 (0.1) | 48 (0.08) |
28–31 weeks | 68 (0.8) | 200 (0.4) | 268 (0.45) |
32–36 weeks | 541 (6.5) | 1547 (3.0) | 2088 (3.53) |
Full term births* | 7625 (91.6) | 48,534 (95.4) | 56,159 (94.9) |
37–38 weeks | 1980 (23.8) | 11,128 (21.9) | 13,108 (22.1) |
39–41 weeks | 5645 (67.8) | 37,406 (73.5) | 43,051 (72.7) |
Post-term births | 82 (1.0) | 545 (1.1) | 627 (1.06) |
LBW | 391 (4.7) | 1304 (2.6) | 1695 (2.86) |
VLBW* | 52 (0.6) | 171 (0.3) | 223 (0.4) |
ELBW | 8 (0.1) | 30 (0.1) | 38 (0.1) |
Multi-births* | 276 (3.3) | 974 (1.9) | 1250 (2.11) |
Congenital anomaliesa | 49 (0.6) | 275 (0.5) | 324 (0.5) |
Amniotic fluid volume* | |||
Normal | 7271 (87.3) | 43,090 (84.7) | 50,361 (85.1) |
Polyhydramnios | 408 (4.9) | 3780 (7.4) | 4188 (7.1) |
Oligohydramnios | 649 (7.8) | 3993 (7.9) | 4642 (7.8) |
Amniotic contamination* | |||
Normal | 7122 (85.5) | 43,949 (86.4) | 51,071 (86.3) |
Grade I | 388 (4.7) | 2536 (5.0) | 2924 (4.9) |
GradeII | 270 (3.2) | 1952 (3.8) | 2222 (3.8) |
Grade III | 548 (6.6) | 2425 (4.8) | 2973 (5.0) |
Apgar score | |||
1-min ≤7* | 375 (4.5) | 1196 (2.4) | 1571 (2.7) |
1-min ≤3* | 70 (0.8) | 277 (0.5) | 347 (0.6) |
5-min ≤7* | 113 (1.4) | 441 (0.9) | 554 (0.9) |
5-min ≤3* | 55 (0.7) | 238 (0.5) | 293 (0.5) |
Fetal deaths/stillbirths* | 34 (0.4) | 133 (0.3) | 167 (0.3) |
Deaths at deliveryb* | 42 (0.5) | 156 (0.3) | 198 (0.3) |
Hospitalized on day 1* | 675 (8.1) | 2589 (5.1) | 3264 (5.5) |
Early neonatal deathsc | 26 (0.3) | 113 (0.2) | 139 (0.2) |
Late neonatal deathsd | 5 (0.06) | 36 (0.07) | 41 (0.07) |
All deathse* | 66 (0.8) | 292 (0.6) | 358 (0.6) |
Birthweight (g) | |||||
---|---|---|---|---|---|
< 1500 | 1500-2499 | 2500-3999 | ≥4000 | Total | |
Birth number (%) | 223 (0.4) | 1472 (2.5) | 49,268 (83.2) | 8227 (13.9) | 59,190 |
Males | 124 (55.6) | 718 (48.8) | 25,509 (51.8) | 5145 (62.5) | 31,496 (53.2) |
Gestational age (weeks)* | 30.3 ± 3.8 | 35.3 ± 2.8 | 39.1 ± 1.2 | 39.6 ± 1.0 | 39.1 ± 1.5 |
Birthweight (grams) | 1164 ± 217 | 2114 ± 267 | 3370 ± 333 | 4220 ± 281 | 3448 ± 507 |
Preterm birth* | 199 (89.2) | 951 (64.6) | 1231 (2.5) | 23 (0.3) | 2404 (4.1) |
Multi-births* | 66 (29.6) | 411 (27.9) | 770 (1.6) | 3 (0.04) | 1250 (2.1) |
Congenital anomaliesa* | 6 (2.7) | 43 (2.9) | 243 (0.5) | 32 (0.4) | 324 (0.5) |
Cesarean delivery* | 100 (44.8) | 891 (60.5) | 25,790 (52.3) | 5445 (66.2) | 32,226 (54.4) |
Pregnancy complications* | 52 (23.3) | 339 (23.0) | 6716 (13.6) | 1221 (14.8) | 8328 (14.1) |
HDP* | 40 (17.9) | 247 (16.8) | 2138 (4.3) | 495 (6.0) | 2920 (4.9) |
PROM* | 52 (23.3) | 290 (19.7) | 4262 (8.7) | 663 (8.1) | 5267 (8.9) |
GDM* | 4 (1.8) | 38 (2.6) | 650 (1.3) | 212 (2.6) | 904 (1.5) |
Anemia* | 32 (14.3) | 212 (14.4) | 3540 (7.2) | 700 (8.5) | 4484 (7.6) |
Antenatal steroidsf | 101 (57.7) | 448(48.5) | 292(24.6) | 3(13.6) | 844 (36.6) |
Maternal age (years) | 27.3 ± 5.4 | 27.0 ± 5.3 | 26.8 ± 4.8 | 27.7 ± 5.0 | 26.9 ± 4.8 |
Delayed childbearing* | 26 (11.7) | 147 (10.0) | 3841 (7.8) | 902 (11.0) | 4916 (8.3) |
> 9 years’ education* | 120 (53.8) | 658 (44.7) | 18,892 (38.3) | 3069 (37.3) | 22,739 (38.4) |
Amniotic fluid volume* | |||||
Normal | 193 (86.5) | 1263 (85.8) | 41,870 (85.0) | 7035 (85.5) | 50,361 (85.1) |
Polyhydramnios | 1 (0.4) | 28 (1.9) | 3443 (7.0) | 716 (8.7) | 4188 (7.1) |
Oligohydramnios | 30 (13.5) | 181 (12.3) | 3955 (8.0) | 476 (5.8) | 4642 (7.8) |
Amniotic contamination* | |||||
Normal | 192 (86.1) | 1326 (90.1) | 42,572 (86.4) | 6981 (84.9) | 51,071 (86.3) |
Grade I | 8 (3.6) | 50 (3.4) | 2413 (4.9) | 453 (5.5) | 2924 (4.9) |
GradeII | 6 (3.0) | 25 (1.7) | 1828 (3.7) | 363 (4.4) | 2222 (3.8) |
Grade III | 17 (7.6) | 71 (4.8) | 2455 (5.0) | 430 (5.2) | 2973 (5.0) |
Apgar score* | |||||
1-min ≤7 | 167 (74.9) | 365 (24.8) | 914 (1.9) | 125 (1.5) | 1571 (2.7) |
1-min ≤3 | 69 (30.9) | 97 (6.6) | 160 (0.3) | 21 (0.3) | 347 (0.6) |
5-min ≤7 | 112 (50.2) | 141 (9.6) | 259 (0.5) | 42 (0.5) | 554 (0.9) |
5-min ≤3 | 52 (23.3) | 71 (4.8) | 139 (0.3) | 31 (0.4) | 293 (0.5) |
Hospitalized on day 1* | 154 (69.1) | 864 (58.7) | 1971 (4.0) | 275 (3.3) | 3264 (5.5) |
IVH/PVH* | 70 (40.5) | 418 (44.9) | 388 (19.2) | 35 (12.6) | 911 (26.8) |
RDS* | 104 (61.1) | 106 (11.4) | 60 (3.0) | 2 (0.7) | 272 (8.0) |
Ventilation* | 119 (68.8) | 263 (28.3) | 245 (12.1) | 26 (9.4) | 653 (19.2) |
Fetal deaths/stillbirths* | 35 (15.7) | 61 (4.1) | 61 (0.1) | 10 (0.1) | 167 (0.3) |
Deaths at birthb | 52 (23.3) | 66 (4.5) | 70 (0.1) | 10 (0.1) | 198 (0.3) |
Early neonatal deathsc* | 36 (16.1) | 26 (1.8) | 71 (0.1) | 6 (0.1) | 139 (0.2) |
Late neonatal deathsd | 6 (2.7) | 9 (0.6) | 20 (0.04) | 6 (0.1) | 41 (0.1) |
All deathse | 82 (36.8) | 97 (6.6) | 157 (0.3) | 22 (0.3) | 358 (0.6) |
Gestational age (weeks) | < 32 | 32–36 | 37–41 | ≥42 | Total |
---|---|---|---|---|---|
All births | 316 (0.5) | 2088 (3.5) | 56,159 (94.9) | 627 (1.1) | 59,190 |
Males* | 191 (60.4) | 1186 (56.8) | 29,817 (53.1) | 302 (48.2) | 31,496 (53.2) |
Gestational age (weeks) | 29.2 ± 1.6 | 34.9 ± 1.3 | 39.2 ± 1.0 | 42.1 ± 0.3 | 39.1 ± 1.5 |
Birthweight (g) | 1464 ± 443 | 2583 ± 546 | 3489 ± 451 | 3677 ± 483 | 3448 ± 507 |
LBW* | 310 (98.1) | 840 (40.2) | 544 (1.0) | 1 (0.2) | 1695 (2.9) |
Multi-births* | 79 (25.0) | 482 (23.1) | 689 (1.2) | 0 (0.0) | 1250 (2.1) |
Congenital anomaliesa* | 16 (5.1) | 38 (1.8) | 267 (0.5) | 3 (0.5) | 325 (0.5) |
Cesarean delivery* | 115 (36.4) | 1296 (62.1) | 30,463 (54.2) | 352 (56.1) | 32,226 (54.4) |
Pregnancy complications* | 80 (25.3) | 541 (25.9) | 7625 (13.6) | 82 (13.1) | 8328 (14.1) |
HDP* | 39 (1.3) | 307 (10.5) | 2535 (86.8) | 39 (1.3) | 2920 (4.9) |
PROM* | 81 (25.6) | 598 (28.6) | 4554 (8.1) | 34 (5.4) | 5267 (8.9) |
GDM* | 9 (2.8) | 96 (4.6) | 796 (1.4) | 3 (0.5) | 904 (1.5) |
Anemia | 51 (16.1) | 347 (16.6) | 4033 (7.2) | 53 (8.5) | 4484 (7.6) |
Antenatal steroidsf | 164 (58.2) | 680(33.6) | 0 | 0 | 844 (36.6) |
Maternal age (years) | 27.4 ± 5.4 | 27.6 ± 5.4 | 26.9 ± 4.8 | 26.1 ± 5.1 | 26.9 ± 4.8 |
Delayed childbearing* | 40 (12.7) | 264 (12.6) | 4565 (8.1) | 47 (7.5) | 4916 (8.3) |
> 9 years’ education* | 160 (50.6) | 1082 (51.8) | 21,363 (38.0) | 134 (21.4) | 22,739 (38.4) |
Amniotic fluid volume* | |||||
Normal | 261 (82.6) | 1842 (88.2) | 47,717 (85.0) | 541 (86.3) | 50,361 (85.1) |
Polyhydramnios | 8 (2.5) | 40 (1.9) | 4136 (7.4) | 4 (0.6) | 4188 (7.1) |
Oligohydramnios | 48 (15.2) | 206 (9.9) | 4306 (7.7) | 82 (13.1) | 4642 (7.8) |
Amniotic contamination* | |||||
Normal | 275 (87.0) | 1949 (93.3) | 48,362 (86.1) | 485 (77.4) | 51,071 (86.3) |
Grade I | 13 (4.1) | 44 (2.1) | 2811 (5.0) | 56 (8.9) | 2924 (4.9) |
Grade II | 9 (2.8) | 21 (1.0) | 2151 (3.8) | 41 (6.5) | 2222 (3.8) |
Grade III | 19 (6.0) | 74 (3.5) | 2835 (5.0) | 45 (7.2) | 2973 (5.0) |
Apgar score | |||||
1-min ≤ 7* | 227 (71.8) | 443 (21.2) | 892 (1.6) | 9 (1.4) | 1571 (2.7) |
1-min ≤ 3* | 97 (30.7) | 91 (4.4) | 158 (0.3) | 1 (0.2) | 347 (0.6) |
5-min ≤ 7* | 155 (49.1) | 133 (6.4) | 262 (0.5) | 4 (0.6) | 554 (0.9) |
5-min ≤3* | 77 (24.4) | 65 (3.1) | 149 (0.3) | 2 (0.3) | 293 (0.5) |
Hospitalized on day 1* | 219 (69.3) | 1191 (57.0) | 1841 (3.3) | 13 (2.1) | 3264 (5.5) |
IVH/PVH* | 125 (52.1) | 534 (40.9) | 248 (13.5) | 4 (30.8) | 911 (26.8) |
RDS* | 132 (55.0) | 104 (8.0) | 36 (2.0) | 0 | 272 (8.0) |
Ventilation* | 167 (69.6) | 282 (21.6) | 204 (11.1) | 0 | 653 (19.2) |
Fetal deaths/stillbirths* | 55 (17.4) | 58 (2.8) | 54 (0.1) | 0 (0) | 167 (0.3) |
Deaths at deliveryb* | 75 (23.7) | 62 (3.0) | 61 (0.1) | 0 | 198 (0.3) |
Early neonatal deathsc* | 44 (13.9) | 32 (1.5) | 62 (0.1) | 1 (0.2) | 139 (0.2) |
Late neonatal deathsd* | 6 (1.9) | 5 (0.2) | 30 (0.1) | 0 | 41 (0.1) |
All deathse* | 110 (34.8) | 95 (4.5) | 151 (0.3) | 2 (0.3) | 358 (0.6) |
Mode of delivery | Vaginal** | Cesarean | Total |
---|---|---|---|
All births | 26,964 (45.6) | 32,226 (54.4) | 59,190 |
Live births, n (%) | 26,827 (99.5) | 32,196 (99.9) | 59,023 (99.7) |
Males* | 13,990 (51.9) | 17,506 (54.3) | 31,496 (53.2) |
Gestational age* (weeks) | 39.2 ± 1.6 | 39.0 ± 1.5 | 39.1 ± 1.5 |
Birthweight* (grams) | 3409 ± 477 | 3481 ± 528 | 3448 ± 507 |
Preterm birth* | 993 (3.7) | 1411 (4.4) | 2404 (4.1) |
LBW* | 704 (2.6) | 991 (3.1) | 1695 (2.9) |
Multi-births* | 233 (0.9) | 1017 (3.2) | 1250 (2.1) |
Congenital anomaliesa | 149 (0.6) | 175 (0.5) | 324 (0.55) |
Maternal age* (years) | 26.4 ± 4.7 | 27.4 ± 4.9 | 26.9 ± 4.8 |
Delayed childbearing | 1851 (1.0) | 3065 (9.5) | 4916 (8.3) |
> 9 years education* | 10,818 (40.1) | 11,921 (37.0) | 22,739 (38.4) |
Pregnancy complications* | 3542 (13.1) | 4786 (14.9) | 8328(14.1) |
HDP* | 532 (2.0) | 2388 (7.4) | 2920 (4.9) |
PROM* | 2163 (8.0) | 3104(9.6) | 5267 (8.9) |
GDM* | 307 (1.1) | 597 (1.9) | 904 (1.5) |
Anemia* | 1577 (5.8) | 2907 (9.0) | 4484 (7.6) |
Antenatal corticosteroidsf | 313 (33.6) | 531 (38.6) | 844 (36.6) |
Amniotic fluid volume* | |||
Normal | 24,109 (89.4) | 26,252 (81.5) | 50,361 (85.1) |
Polyhydramnios | 1670 (6.2) | 2518 (7.8) | 4188 (7.1) |
Oligohydramnios | 1186 (4.4) | 3456 (10.7) | 4642 (7.8) |
Amniotic contamination* | |||
Normal | 23,358 (86.6) | 27,713 (86.0) | 51,071 (86.3) |
Grade I | 1247 (4.6) | 1677 (5.2) | 2924 (4.9) |
Grade II | 937 (3.5) | 1285 (4.0) | 2222 (3.8) |
Grade III | 1422 (5.3) | 1551 (4.8) | 2973 (5.0) |
Apgar score | |||
1-min ≤7 | 755 (2.8) | 816 (2.5) | 1571 (2.7) |
1-min ≤3* | 226 (0.8) | 121 (0.4) | 347 (0.59) |
5-min ≤7* | 316 (1.2) | 238 (0.7) | 554 (0.94) |
5-min ≤3* | 205 (0.8) | 88 (0.3) | 293 (0.50) |
Hospitalized on day 1* | 1338 (5.0) | 1926 (6.0) | 3264 (5.5) |
IVH/PVH | 352 (24.5) | 559 (28.5) | 911 (26.8) |
RDS | 114 (7.9) | 158 (8.1) | 272 (8.0) |
Ventilation* | 236 (16.4) | 417 (21.3) | 653 (19.2) |
Fetal deaths/stillbirths* | 137 (0.5) | 30 (0.1) | 167 (0.3) |
Deaths at deliveryb* | 160 (0.6) | 38 (0.1) | 198 (0.33) |
Early neonatal deathsc | 73 (0.2) | 66 (0.2) | 139 (0.23) |
Late neonatal deathsd | 15 (0.1) | 26 (0.1) | 41 (0.07) |
All deathse* | 221 (0.8) | 137 (0.4) | 358 (0.6) |
Maternal age, years old | < 20 | 20–34 | ≥35 | Total |
---|---|---|---|---|
Maternal age (years) | 18.2 ± 1.0 | 26.2 ± 3.4 | 37.6 ± 2.6 | 26.9 ± 4.8 |
> 9 years’ education | 310 (15.7) | 20,955 (40.1) | 1474 (30.0) | 22,739 (38.4) |
All births, n (%) | 1970 (3.3) | 52,304 (88.4) | 4916 (8.3) | 59,190 |
Live births, n (%) | 1963 (99.6) | 52,166 (99.7) | 4894 (99.6) | 59,023 (99.7) |
Males | 1020 (51.8) | 27,847 (53.2) | 2629 (53.5) | 31,496 (53.2) |
Gestational age (weeks) | 39.1 ± 1.7 | 39.1 ± 1.5 | 38.8 ± 1.7 | 39.1 ± 1.5 |
Birthweight (grams) | 3333 ± 507 | 3448 ± 500 | 3496 ± 565 | 3448 ± 507 |
Preterm birth rate* | 94 (4.8) | 2006 (3.8) | 304 (6.2) | 2404 (4.1) |
LBW* | 87 (4.4) | 1435 (2.7) | 173 (3.5) | 1695 (2.9) |
Multi-birth | 39 (2.0) | 1122 (2.1) | 89 (1.8) | 1250 (2.1) |
Congenital anomaliesa | 13 (0.7) | 280 (0.5) | 31 (0.6) | 324 (0.5) |
Cesarean delivery* | 911 (46.2) | 28,250 (54.0) | 3065 (62.3) | 32,226 (54.4) |
Pregnancy complications* | 275 (14.0) | 7231 (13.8) | 822 (16.7) | 8328 (14.1) |
HDP* | 20 (1.0) | 750 (1.4) | 120 (2.4) | 890 (1.5) |
PROM | 162 (8.2) | 4637 (8.9) | 463 (9.4) | 0.245 |
GDM* | 14 (0.7) | 748 (1.4) | 142 (2.9) | 904 (1.5) |
Anemia* | 141 (7.2) | 3894 (7.4) | 449 (9.1) | 4484 (7.6) |
Antenatal steroidsf | 27 (30.0) | 706 (36.8) | 111(37.6) | 844 (36.6) |
Amniotic fluid volume* | ||||
Normal | 1638 (83.1) | 44,577 (85.2) | 4146 (84.3) | 50,361 (85.1) |
Polyhydramnios | 141 (7.2) | 3674 (7.0) | 373 (7.6) | 4188 (7.1) |
Oligohydramnios | 191 (9.7) | 4054 (7.8) | 397 (8.1) | 4642 (7.8) |
Amniotic contamination | ||||
Normal | 1666 (84.6) | 45,194 (86.4) | 4211 (85.7) | 51,071 (86.3) |
Grade I | 111 (5.6) | 2555 (4.9) | 258 (5.2) | 2924 (4.9) |
Grade II | 89 (4.5) | 1962 (3.8) | 171 (3.5) | 2222 (3.8) |
Grade III | 104 (5.3) | 2593 (5.0) | 276 (5.6) | 2973 (5.0) |
Apgar score | ||||
1-min ≤7* | 76 (3.9) | 1320 (2.5) | 175 (3.6) | 1571 (2.7) |
1-min ≤3* | 15 (0.8) | 284 (0.5) | 48 (1.0) | 347 (0.6) |
5-min ≤7** | 25 (1.3) | 463 (0.9) | 66 (1.3) | 554 (0.9) |
5-min ≤3** | 10 (0.5) | 248 (0.5) | 35 (0.7) | 293 (0.5) |
Fetal deaths/stillbirths | 7 (0.4) | 138 (0.3) | 22 (0.4) | 167 (0.3) |
Deaths at deliveryb | 7 (0.4) | 168 (0.3) | 23 (0.5) | 198 (0.3) |
Hospitalized on day 1* | 125 (6.3) | 2785 (5.3) | 354 (7.2) | 3265 (5.5) |
Early neonatal deathsc | 4 (0.2) | 123 (0.2) | 12 (0.2) | 139 (0.2) |
Late neonatal deathsd | 0 | 36 (0.1) | 5(0.1) | 41 (0.1) |
All deathse | 11 (0.6) | 308 (0.6) | 39 (0.8) | 358 (0.6) |
Education years | < 7 | 7–9 | 10–12 | >12 | Total |
---|---|---|---|---|---|
Maternal age (years) | 28.1 ± 6.1 | 26.5 ± 5.0 | 26.8 ± 4.5 | 27.3 ± 3.9 | 26.9 ± 4.9 |
Delayed childbearing* | 1094 (16.8) | 2348 (7.8) | 773 (7.1) | 701 (5.9) | 4916 (8.3) |
All births | 6526 (11.0) | 29,925 (50.6) | 10,941 (18.5) | 11,798 (19.9) | 59,190 |
Live births, n (%) | 6508 (99.7) | 29,855 (99.8) | 10,891 (99.5) | 11,769 (99.8) | 59,023 (99.7) |
Males* | 3337(51.1) | 16,234 (54.2) | 5807 (53.1) | 6118 (51.9) | 31,496 (53.2) |
Gestational age (weeks) | 39.1 ± 1.5 | 39.1 ± 1.4 | 39.0 ± 1.7 | 39.0 ± 1.6 | 39.1 ± 1.5 |
Birthweight (g) | 3433 ± 511 | 3461 ± 498 | 3426 ± 523 | 3444 ± 511 | 3438 ± 507 |
Preterm birth rate* | 236 (3.6) | 926 (3.1) | 620 (5.7) | 622 (5.3) | 2404 (4.1) |
LBW* | 206 (3.2) | 711 (2.4) | 379 (3.5) | 399 (3.4) | 1695 (2.9) |
Congenital anomalies | 37 (0.6) | 149 (0.5) | 64 (0.6) | 74 (0.6) | 324 (0.5) |
Cesarean delivery | 3560 (54.6) | 16,745 (56.0) | 5936 (54.3) | 5985 (50.7) | 32,226 (54.4) |
Multi-births* | 103 (1.6) | 488 (1.6) | 315 (2.9) | 344 (2.9) | 1250 (2.1) |
Pregnancy complications* | 880 (13.5) | 3797 (12.7) | 1636 (15.0) | 2015 (17.1) | 8328 (14.1) |
Pregnant hypertension* | 386 (5.9) | 1438 (4.8) | 522 (4.8) | 574 (4.9) | 2920 (4.9) |
PROM* | 406 (6.2) | 2322 (7.8) | 1131 (10.3) | 1408 (11.9) | 5267 (8.9) |
GDM* | 51 (0.8) | 250 (0.8) | 235 (2.1) | 368 (3.1) | 904 (1.5) |
Anemia | 467 (7.2) | 1909 (6.4) | 932 (8.5) | 1176 (10.0) | 4484 (7.6) |
Antenatal steroidsf | 106 (47.5) | 334 (37.7) | 199 (33.3) | 205 (34.3) | 844 (36.6) |
Amniotic fluid volume* | < 0.001 | ||||
Normal | 5688 (87.2) | 25,476 (85.1) | 9253 (84.6) | 9944 (84.3) | 50,361 (85.1) |
Polyhydramnios | 288 (4.4) | 2044 (6.8) | 856 (7.8) | 1000 (8.5) | 4188 (7.1) |
Oligohydramnios | 550 (8.4) | 2406 (8.0) | 832 (7.6) | 854 (7.2) | 4642 (7.8) |
Amniotic contamination* | < 0.001 | ||||
Normal | 5644 (86.5) | 25,697 (85.9) | 9477 (86.6) | 10,253 (86.9) | 51,071 (86.3) |
Grade I | 424 (6.5) | 1695 (5.7) | 452 (4.1) | 353 (3.0) | 2924 (4.9) |
Grade II | 220 (3.4) | 1220 (4.1) | 390 (3.6) | 392 (3.3) | 2222 (3.8) |
Grade III | 238 (3.6) | 1313 (4.4) | 622 (5.7) | 800 (6.8) | 2973 (5.0) |
Apgar score | |||||
1-min ≤ 7 | 155 (2.4) | 672 (2.2) | 361 (3.3) | 383 (3.2) | 1571 (2.7) |
1-min ≤3 | 37 (0.6) | 149 (0.5) | 85 (0.8) | 76 (0.6) | 347 (0.6) |
5-min ≤7** | 58 (0.9) | 247 (0.8) | 137 (1.3) | 112 (0.9) | 554 (0.9) |
5-min ≤3** | 29 (0.4) | 134 (0.4) | 74 (0.7) | 56 (0.5) | 293 (0.5) |
Fetal deaths/stillbirths* | 18 (0.3) | 70 (0.2) | 50 (0.5) | 29 (0.2) | 167 (0.3) |
Deaths at deliveryb** | 19 (0.3) | 85 (0.3) | 54 (0.5) | 40 (0.3) | 198 (0.3) |
Hospitalized on day 1* | 330 (5.1) | 1344 (4.5) | 745 (6.8) | 845 (7.2) | 3265 (5.5) |
Early neonatal deathsc** | 10 (0.2) | 62 (0.2) | 40 (0.4) | 27 (0.2) | 139 (0.2) |
Late neonatal deathsd | 3 | 25 (0.1) | 5 | 8 (0.1) | 41 (0.1) |
All deathse | 32 (0.5) | 160 (0.5) | 101 (0.9) | 65 (0.6) | 358 (0.6) |
Risk factors for perinatal outcome
A. Univariable logistic regression analysis | |||||
Variables | Category | Mortality (%) | OR | 95% CI | P values |
Hospital level | III | 1.1 | |||
II | 0.6 | 0.503 | 0.403–0.629 | < 0.001 | |
I | 0.2 | 0.187 | 0.131–0.266 | < 0.001 | |
Sex | Male | 0.7 | |||
Female | 0.5 | 0.777 | 0.628–0.960 | 0.019 | |
Multi-births | No | 0.5 | |||
Yes | 4.8 | 9.753 | 7.347–12.946 | < 0.001 | |
Congenital anomalies | No | 0.5 | |||
Yes | 13.6 | 29.303 | 20.927–41.030 | < 0.001 | |
Cesarean delivery | No | 0.8 | |||
Yes | 0.4 | 0.517 | 0.417–0.640 | < 0.001 | |
High risk pregnancy | No | 0.2 | |||
Yes | 0.8 | 4.382 | 2.939–6.535 | < 0.001 | |
Pregnancy complications | No | 0.6 | |||
Yes | 0.8 | 1.383 | 1.058–1.809 | 0.018 | |
Low birthweight (< 2500 g) | No | 0.3 | |||
Yes | 10.6 | 37.807 | 30.543–46.799 | < 0.001 | |
Preterm birth (< 37 weeks) | No | 0.3 | |||
Yes | 8.5 | 34.507 | 27.868–42.728 | < 0.001 | |
Maternal education (< 10 years) | No | 0.7 | |||
Yes | 0.5 | 0.720 | 0.585–0.887 | 0.002 | |
Maternal age (≥35 years old) | No | 0.6 | |||
Yes | 0.8 | 1.353 | 0.969–1.888 | 0.073 | |
AF contamination | No | 0.5 | |||
Yes | 1.3 | 2.741 | 2.185–3.439 | < 0.001 | |
Abnormal amniotic fluid volume | No | 0.6 | |||
Yes | 0.8 | 1.516 | 1.174–1.958 | 0.001 | |
First delivery | No | 0.5 | |||
Yes | 0.8 | 1.716 | 1.392–2.114 | <0.001 | |
1-min Apgar (≤7) | No | 0.2 | |||
Yes | 16.6 | 118.149 | 92.994–150.110 | < 0.001 | |
5-min Apgar (≤7) | No | 0.2 | |||
Yes | 43.7 | 391.298 | 305.437–501.294 | < 0.001 | |
B. Multivariable logistic regression analysis | |||||
Variables | Referenceb | OR | 95%CI | P values | |
Lower | Upper | ||||
Hospital level | I | 0.729 | 0.456 | 1.166 | 0.187 |
II | 0.925 | 0.670 | 1.276 | 0.634 | |
Sex | Male | 0.815 | 0.619 | 1.074 | 0.146 |
Multi-births | No | 2.331 | 1.451 | 3.744 | < 0.001 |
Congenital anomalies | No | 14.699 | 7.850 | 27.527 | < 0.001 |
High risk pregnancy | No | 1.510 | 0.941 | 2.422 | 0.088 |
Cesarean delivery | No | 0.635 | 0.480 | 0.840 | 0.001 |
LBW (< 2500 g) | No | 1.362 | 0.875 | 2.119 | 0.171 |
Preterm birth (< 37 weeks) | No | 2.606 | 1.640 | 4.140 | < 0.001 |
Maternal education (< 10 years) | No | 1.005 | 0.749 | 1.350 | 0.972 |
Maternal age (≥ 35 years old) | No | 1.069 | 0.681 | 1.678 | 0.772 |
AF contamination | No | 1.997 | 1.446 | 2.758 | < 0.001 |
Abnormal amniotic fluid volume | No | 1.322 | 0.925 | 1.889 | 0.125 |
First delivery | No | 0.838 | 0.616 | 1.140 | 0.260 |
1-min Apgar (≤7) | No | 5.922 | 3.805 | 9.218 | < 0.001 |
5-min Apgar (≤7) | No | 40.593 | 26.845 | 61.380 | < 0.001 |