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Background <p>The perinatal mortality rate is a proxy indicator of healthcare quality for mothers and newborns. Unfortunately, Pakistan faces poor pregnancy outcomes, which are significantly worse than those of many other low-resource countries worldwide. Recognizing the need to achieve a substantial reduction in perinatal mortality in Pakistan, the set of targets under Sustainable Development Goal 3 demands a significant decrease in this metric.</p> Methods <p>SPSS data files from the Pakistan Maternal Mortality Survey 2019 (1), with a sample of 136,226 households, was used. The PNMR was computed for urban and rural areas for the regions and provinces of Pakistan and for each category of the common risk factors (independent variables). We applied the chi-square test to determine whether the correlations between the PNMR and the independent variables were statistically significant. Finally, binary logistic regression analysis was conducted via SPSS version 19.0 to compute the adjusted odds ratio (AOR).</p> Results <p>The PNMR for the entire sample was 70.1 per 1000 live births. Geographical differences were not statistically significant, except in the Gilgit-Baltistan (GB) region, which had a lower PNMR. We identified the lowest PNMR among the highest quintile, primigravida women with 3–5 pregnancies, aged 24–35 years, with at least 10 years of education, who received adequate antenatal care, and who delivered at home without skilled birth attendants. Binary logistic regression analysis showed a twofold higher risk among the lowest wealth quintile: 1.37 times higher among women over 35 years old and 1.5 times higher among women who had skilled birth attendance. After adjusting for socioeconomic and demographic variables, parity and antenatal care were not associated with perinatal deaths.</p> Discussion &amp; Conclusion <p>We found no increase in the risk of PNMR among women younger than 25 years and using antenatal care, whereas other studies reported a greater risk of PNMR among younger and adolescent mothers. Therefore, more robust primary studies are needed to determine the associations of the key variables with perinatal mortality in Pakistan.</p>

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Why & where perinatal deaths: trends and determinants in Pakistan

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月8日

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  • Qudsia Uzma,
  • Farid Midhet,
  • Samina Naeem Khalid,
  • Sayema Awais,
  • Ellen Thom

摘要

Background

The perinatal mortality rate is a proxy indicator of healthcare quality for mothers and newborns. Unfortunately, Pakistan faces poor pregnancy outcomes, which are significantly worse than those of many other low-resource countries worldwide. Recognizing the need to achieve a substantial reduction in perinatal mortality in Pakistan, the set of targets under Sustainable Development Goal 3 demands a significant decrease in this metric.

Methods

SPSS data files from the Pakistan Maternal Mortality Survey 2019 (1), with a sample of 136,226 households, was used. The PNMR was computed for urban and rural areas for the regions and provinces of Pakistan and for each category of the common risk factors (independent variables). We applied the chi-square test to determine whether the correlations between the PNMR and the independent variables were statistically significant. Finally, binary logistic regression analysis was conducted via SPSS version 19.0 to compute the adjusted odds ratio (AOR).

Results

The PNMR for the entire sample was 70.1 per 1000 live births. Geographical differences were not statistically significant, except in the Gilgit-Baltistan (GB) region, which had a lower PNMR. We identified the lowest PNMR among the highest quintile, primigravida women with 3–5 pregnancies, aged 24–35 years, with at least 10 years of education, who received adequate antenatal care, and who delivered at home without skilled birth attendants. Binary logistic regression analysis showed a twofold higher risk among the lowest wealth quintile: 1.37 times higher among women over 35 years old and 1.5 times higher among women who had skilled birth attendance. After adjusting for socioeconomic and demographic variables, parity and antenatal care were not associated with perinatal deaths.

Discussion & Conclusion

We found no increase in the risk of PNMR among women younger than 25 years and using antenatal care, whereas other studies reported a greater risk of PNMR among younger and adolescent mothers. Therefore, more robust primary studies are needed to determine the associations of the key variables with perinatal mortality in Pakistan.