Abstract
BackgroundOur study aims to evaluate the current perinatal registry, analyze national childbirth outcomes and study ethnic disparities in middle-income country Suriname, South America.MethodsA nationwide birth registry study was conducted in Suriname. Data were collected for 2016 and 2017 from the childbirth books of all five hospital maternity wards, covering 86% of all births in the country. Multinomial regression analyses were used to assess ethnic disparities in outcomes of maternal deaths, stillbirths, teenage pregnancy, cesarean delivery, low birth weight and preterm birth with Hindustani women as reference group.Results18.290 women gave birth to 18.118 (98%) live born children in the five hospitals. Hospital-based maternal mortality ratio was 112 per 100.000 live births. Hospital-based late stillbirth rate was 16 per 1000 births. Stillbirth rate was highest among Maroon (African-descendent) women (25 per 1000 births, aOR 2.0 (95%CI 1.3–2.8) and lowest among Javanese women (6 stillbirths per 1000 births, aOR 0.5, 95%CI 0.2–1.2). Preterm birth and low birthweight occurred in 14 and 15% of all births. Teenage pregnancy accounted for 14% of all births and was higher in Maroon women (18%) compared to Hindustani women (10%, aOR 2.1, 95%CI 1.8–2.4). The national cesarean section rate was 24% and was lower in Maroon (17%) than in Hindustani (32%) women (aOR 0.5 (95%CI 0.5–0.6)). Cesarean section rates varied between the hospitals from 17 to 36%.ConclusionThis is the first nationwide comprehensive overview of maternal and perinatal health in a middle income country. Disaggregated perinatal health data in Suriname shows substantial inequities in outcomes by ethnicity which need to be targetted by health professionals, researchers and policy makers.
Highlights
Our study aims to evaluate the current perinatal registry, analyze national childbirth outcomes and study ethnic disparities in middle-income country Suriname, South America
Plain English summary In middle-income country Suriname we studied all hospital births to describe childbirth outcomes and to discover inequities by ethnicity
There are substantial inequities by ethnicity with Maroon women experiencing the highest risk on adverse outcomes
Summary
Our study aims to evaluate the current perinatal registry, analyze national childbirth outcomes and study ethnic disparities in middle-income country Suriname, South America. The Global Strategy for Women’s, Children’s and Adolescents’ Health, 2016–2030 is a roadmap for ending all preventable maternal and newborn deaths (including stillbirths) and is central to the achievement of the SDGs [5]. This strategy urgently calls for the extension and strengthening of health information systems to generate high quality data and evidence to measure progress and be able to reach the target of a global maternal mortality ratio (MMR) under 70 per 100.000 live births and stillbirth rate (SBR) under 12 stillbirths per 1000 births [2, 6]. An upper middle-income country, is one of the countries where SIP will be re-launched after a previous attempt in 2014, which failed for unknown reasons [11]
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