Table 2. Trends of and pooled perinatal mortality rate in Bangladesh between 2004 and 2014.
| Characteristics | n1 | PNMR (95% CI) | % reduced2 | P3 | Pooled PNMR (95% CI) | P4 | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| 2004 | 2007 | 2011 | 2014 | ||||||||
| Household characteristics | |||||||||||
| Administrative division | |||||||||||
| Barisal | 1522 | 44 (30–64) | 68 (49–94) | 56 (40–79) | 33 (21–53) | 25.0 | 0.346 | 50 (41–61) | <0.001 | ||
| Chittagong | 5811 | 62 (46–84) | 40 (28–56) | 28 (21–39) | 32 (22–45) | 48.4 | <0.001 | 39 (33–46) | |||
| Dhaka | 8564 | 58 (46–73) | 54 (40–72) | 52 (40–66) | 35 (24–50) | 39.7 | <0.001 | 49 (42–56) | |||
| Khulna | 2438 | 61 (41–90) | 45 (31–66) | 56 (40–79) | 48 (31–72) | 21.3 | 0.476 | 53 (44–65) | |||
| Rajshahi | 4282 | 79 (64–98) | 65 (46–92) | 61 (47–79) | 48 (33–68) | 39.2 | 0.005 | 66 (57–76) | |||
| Rangpur5 | 1575 | - | - | 46 (35–62) | 37 (24–58) | 19.6 | 0.341 | 42 (32–55) | |||
| Sylhet | 2412 | 70 (54–91) | 63 (42–92) | 64 (47–85) | 75 (56–100) | -7.1 | 0.704 | 69 (59–80) | |||
| Place of residence | |||||||||||
| Rural | 20602 | 65 (56–74) | 57 (48–68) | 49 (42–56) | 44 (37–53) | 32.3 | <0.001 | 53 (49–57) | 0.036 | ||
| Urban | 6002 | 63 (51–79) | 43 (32–56) | 49 (38–63) | 31 (23–41) | 50.8 | <0.001 | 45 (40–51) | |||
| Household wealth quintile | |||||||||||
| Poorest | 6508 | 65 (51–84) | 54 (39–74) | 48 (38–60) | 54 (40–72) | 16.9 | 0.094 | 55 (48–63) | 0.008 | ||
| Poorer | 5473 | 63 (50–79) | 58 (42–79) | 56 (44–70) | 51 (38–69) | 19.0 | 0.223 | 57 (50–65) | |||
| Middle | 5053 | 71 (55–90) | 71 (52–95) | 50 (37–68) | 40 (28–58) | 43.7 | <0.001 | 57 (49–66) | |||
| Richer | 4932 | 62 (40–95) | 53 (39–71) | 47 (36–62) | 28 (20–40) | 54.8 | <0.001 | 46 (38–55) | |||
| Richest | 4637 | 60 (46–77) | 34 (23–50) | 41 (30–56) | 28 (19–40) | 53.3 | <0.001 | 40 (34–47) | |||
| Type of cooking fuel | |||||||||||
| Non-solid | 2947 | 59 (41–83) | 27 (15–47) | 38 (27–55) | 23 (14–37) | 61.0 | 0.003 | 34 (27–42) | <0.001 | ||
| Solid | 23657 | 65 (57–74) | 57 (48–66) | 50 (44–57) | 44 (37–52) | 32.3 | <0.001 | 54 (50–57) | |||
| Source of drinking water | |||||||||||
| Unimproved | 745 | 60 (36–98) | 60 (34–103) | 70 (33–143) | 68 (44–102) | -13.3 | 0.619 | 64 (48–84) | 0.128 | ||
| Improved | 25859 | 65 (57–73) | 54 (46–63) | 48 (43–55) | 40 (34–47) | 38.5 | <0.001 | 51 (48–55) | |||
| Type of toilet facility | |||||||||||
| Unimproved | 12587 | 65 (55–77) | 56 (47–68) | 54 (46–63) | 51 (40–65) | 21.5 | 0.022 | 57 (52–62) | 0.007 | ||
| Improved | 14017 | 64 (53–76) | 51 (39–65) | 43 (36–52) | 35 (29–43) | 45.3 | <0.001 | 47 (42–52) | |||
| Child characteristics | |||||||||||
| Gender | |||||||||||
| Male | 13627 | 63 (54–74) | 56 (47–67) | 54 (46–63) | 42 (34–53) | 33.3 | <0.001 | 53 (49–58) | 0.208 | ||
| Female | 12977 | 66 (56–77) | 52 (42–65) | 43 (36–51) | 39 (31–49) | 40.9 | <0.001 | 49 (45–54) | |||
| Maternal characteristics | |||||||||||
| Age at child's birth (years) | |||||||||||
| <20 | 8268 | 74 (61–90) | 65 (53–79) | 60 (50–72) | 42 (33–54) | 43.2 | <0.001 | 60 (54–66) | 0.007 | ||
| 20–29 | 14210 | 59 (49–71) | 55 (44–68) | 45 (38–53) | 39 (32–49) | 33.9 | <0.001 | 48 (44–54) | |||
| 30–39 | 3822 | 61 (45–82) | 32 (22–47) | 38 (27–54) | 43 (27–67) | 29.5 | 0.114 | 44 (36–53) | |||
| ≥40 | 305 | 70 (29–161) | 44 (9–180) | 52 (16–152) | 41 (12–131) | 41.4 | 0.539 | 54 (31–93) | |||
| Level of education | |||||||||||
| No education | 7004 | 73 (61–88) | 60 (45–81) | 42 (32–56) | 41 (28–59) | 43.8 | <0.001 | 57 (50–65) | 0.025 | ||
| Primary incomplete | 5214 | 54 (39–74) | 49 (37–65) | 54 (42–69) | 50 (35–72) | 7.4 | 0.786 | 52 (44–61) | |||
| Primary complete6 | 2888 | 65 (44–94) | 81 (56–115) | 45 (32–63) | 56 (39–79) | 13.8 | 0.091 | 58 (49–70) | |||
| Secondary incomplete | 8491 | 61 (47–78) | 49 (38–63) | 52 (42–63) | 38 (30–49) | 37.7 | 0.002 | 48 (43–54) | |||
| Secondary complete or higher7 | 3008 | 56 (35–67) | 40 (25–63) | 48 (33–69) | 26 (17–39) | 53.6 | 0.012 | 39 (32–49) | |||
| Occupation | |||||||||||
| Homemaker | 21096 | 62 (54–71) | 56 (47–66) | 46 (40–52) | 41 (34–49) | 33.9 | <0.001 | 50 (47–54) | 0.228 | ||
| Employed | 5508 | 73 (58–92) | 51 (39–67) | 75 (57–99) | 40 (30–54) | 45.2 | 0.002 | 55 (48–63) | |||
| Religion | |||||||||||
| Islam | 24378 | 65 (57–73) | 55 (47–64) | 49 (43–55) | 42 (35–49) | 35.4 | <0.001 | 52 (48–56) | 0.335 | ||
| Others8 | 2226 | 60 (41–87) | 50 (26–95) | 49 (33–71) | 30 (16–54) | 50.0 | 0.017 | 46 (36–58) | |||
| Body mass index (kg/m2) | |||||||||||
| <18.5 | 7854 | 62 (50–77) | 67 (54–83) | 42 (33–54) | 38 (26–54) | 38.7 | <0.001 | 53 (47–60) | 0.256 | ||
| 18.5–24.9 | 15800 | 66 (57–77) | 49 (40–59) | 52 (44–60) | 44 (35–54) | 33.3 | <0.001 | 52 (48–57) | |||
| 25–29.9 | 2491 | 60 (33–107) | 46 (24–86) | 44 (30–64) | 32 (23–44) | 46.7 | 0.028 | 41 (32–51) | |||
| ≥30 | 459 | 70 (23–198) | 40 (15–103) | 77 (36–156) | 49 (19–119) | 30.0 | 0.608 | 59 (36–96) | |||
| Exposure to media9 | |||||||||||
| No | 10215 | 67 (55–81) | 57 (45–73) | 49 (40–58) | 56 (44–70) | 16.4 | 0.041 | 56 (51–63) | 0.019 | ||
| Yes | 16389 | 63 (54–73) | 52 (44–62) | 49 (42–57) | 31 (25–38) | 50.8 | <0.001 | 48 (44–52) | |||
| Birth order and birth interval | |||||||||||
| First birth | 8607 | 97 (81–115) | 75 (62–91) | 73 (62–86) | 51 (41–62) | 47.4 | <0.001 | 71 (65–78) | <0.001 | ||
| 2nd birth, <2 years interval | 979 | 71 (44–114) | 61 (35–106) | 84 (54–128) | 37 (16–81) | 47.9 | 0.301 | 64 (49–83) | |||
| 3rd/later birth, <2 years interval | 1404 | 54 (36–81) | 89 (55–141) | 34 (19–63) | 40 (19–83) | 25.9 | 0.093 | 55 (42–72) | |||
| 2nd birth, ≥2 years interval | 6379 | 49 (37–64) | 42 (29–60) | 37 (28–49) | 33 (24–44) | 32.7 | 0.016 | 39 (34–45) | |||
| 3rd/later birth, ≥2 years interval | 9235 | 52 (43–63) | 37 (27–50) | 31 (25–40) | 36 (27–49) | 30.8 | 0.001 | 39 (35–45) | |||
| Previously pregnancies miscarried or aborted | |||||||||||
| No | 24615 | 67 (59–76) | 47 (40–55) | 43 (38–50) | 37 (32–44) | 44.8 | <0.001 | 48 (45–52) | <0.001 | ||
| Yes | 1989 | 33 (19–55) | 144 (104–196) | 117 (85–159) | 87 (61–122) | -163.6 | <0.001 | 92 (77–110) | |||
| Previous death of any child | |||||||||||
| No | 25239 | 57 (50–66) | 46 (39–54) | 45 (39–51) | 37 (31–44) | 35.1 | <0.001 | 46 (42–49) | <0.001 | ||
| Yes | 1365 | 139 (107–180) | 171 (118–240) | 150 (103–213) | 213 (131–329) | -53.2 | 0.077 | 159 (133–188) | |||
| Number of children in last five years | |||||||||||
| 1 | 17597 | 51 (44–60) | 44 (37–53) | 38 (33–45) | 32 (27–39) | 37.3 | <0.001 | 40 (37–44) | <0.001 | ||
| 2 | 8031 | 73 (60–89) | 56 (43–72) | 68 (55–84) | 57 (45–73) | 21.9 | 0.153 | 65 (58–73) | |||
| 3+ | 977 | 135 (93–192) | 180 (118–265) | 109 (71–164) | 140 (75–246) | -3.7 | 0.611 | 142 (111–180) | |||
| Number of antenatal care visits | |||||||||||
| <4 | 22201 | 65 (57–73) | 54 (46–64) | 50 (44–57) | 42 (36–49) | 35.4 | <0.001 | 52 (49–56) | 0.119 | ||
| 4+ | 4403 | 61 (44–82) | 53 (38–74) | 44 (34–57) | 35 (25–50) | 42.6 | 0.005 | 46 (39–54) | |||
| Place and mode of delivery | |||||||||||
| Home | 18823 | 61 (54–70) | 53 (45–63) | 43 (37–50) | 39 (30–51) | 36.1 | <0.001 | 50 (47–55) | 0.198 | ||
| Health facilities without C-section | 5047 | 99 (67–142) | 62 (42–89) | 57 (41–78) | 42 (34–52) | 57.6 | <0.001 | 50 (43–58) | |||
| Health facilities with C-section | 2734 | 91 (60–136) | 57 (35–89) | 75 (58–97) | 41 (29–56) | 54.9 | 0.006 | 60 (50–71) | |||
| Type of delivery | |||||||||||
| Single birth | 26188 | 63 (56–71) | 52 (45–61) | 47 (41–53) | 38 (32–45) | 39.7 | <0.001 | 49 (46–53) | <0.001 | ||
| Twin | 416 | 139 (68–262) | 181 (90–332) | 156 (89–260) | 221 (120–372) | -59.0 | 0.181 | 173 (125–233) | |||
| Access to participation in decision-making10 | |||||||||||
| No | 16761 | 66 (57–76) | 58 (49–70) | 55 (47–63) | 47 (39–57) | 28.8 | <0.001 | 57 (52–61) | <0.001 | ||
| Yes | 9659 | 61 (48–76) | 47 (36–61) | 40 (32–48) | 33 (25–42) | 45.9 | <0.001 | 42 (38–47) | |||
| Paternal characteristics | |||||||||||
| Level of education | |||||||||||
| No education | 8968 | 75 (62–89) | 61 (48–78) | 49 (39–60) | 47 (35–63) | 37.3 | <0.001 | 59 (52–66) | 0.005 | ||
| Primary incomplete | 4710 | 53 (39–72) | 53 (38–73) | 54 (41–71) | 44 (31–62) | 17.0 | 0.341 | 51 (44–59) | |||
| Primary complete6 | 3065 | 67 (48–93) | 61 (40–92) | 43 (30–62) | 43 (28–66) | 35.8 | 0.012 | 51 (42–62) | |||
| Secondary incomplete | 5619 | 64 (47–87) | 51 (38–68) | 49 (38–62) | 41 (31–54) | 35.9 | 0.007 | 50 (43–58) | |||
| Secondary complete or higher7 | 4241 | 43 (29–61) | 40 (27–59) | 48 (34–66) | 27 (18–41) | 37.2 | 0.123 | 39 (32–47) | |||
| Occupation | |||||||||||
| Agriculture | 7224 | 81 (66–100) | 52 (37–74) | 52 (41–65) | 51 (39–67) | 37.0 | <0.001 | 59 (52–67) | <0.001 | ||
| White-collar11 | 1088 | 45 (19–104) | 34 (15–75) | 44 (25–76) | 33 (19–56) | 26.7 | 0.595 | 38 (27–53) | |||
| Blue-collar12 | 11844 | 61 (51–72) | 66 (54–81) | 53 (44–63) | 40 (31–52) | 34.4 | <0.001 | 54 (49–60) | |||
| Pink-collar13 | 5728 | 54 (40–74) | 39 (28–53) | 39 (29–51) | 32 (23–45) | 40.7 | 0.005 | 41 (35–48) | |||
| Others14 | 721 | 37 (14–90) | 11 (2–49) | 32 (14–69) | 38 (16–87) | -2.7 | 0.504 | 31 (19–49) | |||
| Overall | 26604 | 64 (57–73) | 54 (47–63) | 49 (43–55) | 41 (35–48) | 35.9 | <0.001 | 51 (48–55) | |||
1Number of pregnancies of seven or more months’ duration
2% reduction from the year 2004 to 2014
3P-value for the Cochran–Armitage test of % of PNMR reduction from the year 2004 to 2014
4P-value for the Chi-square test of pooled PNMR
5The administrative division Rangpur was created in 2010
6Primary complete is defined as completing grade 5
7Secondary complete is defined as completing grade 10
8Others = Hindu, Christian, Buddhist, etcetera
9Exposure to media = Watches TV/listens to radio/reads newspaper in the previous week
10Access to participation in decision-making = having access to take decision alone or jointly with husband on all of the four components: own health care, major household purchases, child health care, and visits to her family or relatives
11Doctor, lawyer, dentist, accountant, teacher, nurse, family welfare visitor
12Non-agricultural worker, carpenter, mason, bus/taxi driver, construction supervisor, tailor, rickshaw driver, brick breaking, road building, construction worker, boatman, fisherman, poultry raising, cattle raising
13Businessman/trader
14Unemployed/student, retired, beggar, etcetera.