Document Detail

Reproductive pattern, perinatal mortality, and sex preference in rural Tamil Nadu, south India: community based, cross sectional study.
MedLine Citation:
PMID:  9169399     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To study reproductive pattern and perinatal mortality in rural Tamil Nadu, South India. DESIGN: Community based, cross sectional questionnaire study of 30 randomly selected areas served by health subcentres. SETTING: Rural parts of Salem District, Tamil Nadu, South India. SUBJECTS: 1321 women and their offspring delivered in the 6 months before the interview. MAIN OUTCOME MEASURES: Number of pregnancies, pregnancy outcome, spacing of pregnancies, sex of offspring, perinatal and neonatal mortality rates. RESULTS: 41% of the women (535) were primiparous; 7 women (0.5%) were grand multiparous (> 6 births). The women had a mean age of 22 years and a mean of 2.3 pregnancies and 1.8 live children. The sex ratio at birth of the index children was 107 boys per 100 girls. The stillbirth rate was 13.5/1000 births, the neonatal mortality rate was 35.3/1000, and the perinatal mortality rate was 42.0/1000. Girls had an excess neonatal mortality (rate ratio 3.42%; 95% confidence interval 1.68 to 6.98; this was most pronounced among girls born to multiparous women with no living sons (rate ratio 15.48 (2.04 to 177.73) v 1.87 (0.63 to 5.58) in multiparous women with at least one son alive). CONCLUSIONS: In this rural part of Tamil Nadu, women had a controlled reproductive pattern. The excess neonatal mortality among girls constitutes about one third of the perinatal mortality rate. It seems to be linked to a preference for sons and should therefore be addressed through a holistic societal approach rather than through specific healthcare measures.
This study examines patterns of neonatal mortality among rural mothers in Salem district, Tamil Nadu state, India. Data were collected during August-September 1995 in a catchment area of 30 health subcenters. The sample includes 1321 women who had delivered within the preceding 6 months. The aim was to determine the extent of excess female neonatal mortality. The instrument was pretested, and other reliability checks were made. Findings indicate that 20% (261) of the mothers had experienced the death of one or more children. The mean age of the women was 22 years, the average number of pregnancies was 2.3, and the average number of live-born children was 1.8. The mean age of first-time mothers was 20.2 years. The mean age of multiparous women was 23.9 years. There were 268 live-born babies, 68 stillbirths, 275 postnatal deaths, 280 spontaneous abortions, and 60 induced abortions. The stillbirth rate was 13.5/1000 births. The perinatal mortality rate was 42.0/1000. The early neonatal mortality rate was 28.9/1000. The late neonatal mortality rate was 6.6/1000. Of the 1321 deliveries in the prior 6 months, 99% were singleton births. 51.7% were boys, and 48.3% were girls. 98.6% were live-born, and 1.4% were stillbirths. 4.0% of live-born infants died postnatally, of which 64% died in the first 7 days and 13% died between 8 and 28 days. 23% died 1 month or more following birth. There were 11 sets of twins, of which one each died in the early and late neonatal period. In the one set of quadruplets, all infants died in the early neonatal period. The relative risk of death among daughters was 4.36 compared to sons. Primiparous women did not experience excess female neonatal mortality. Risk of female neonatal death was higher among multiparous women with no living sons compared to women with at least one son. This study did not find a shorter birth interval after the birth of a girl. The preference for sons should be addressed through a holistic societal approach.
B B Nielsen; J Liljestrand; M Hedegaard; S H Thilsted; A Joseph
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  BMJ (Clinical research ed.)     Volume:  314     ISSN:  0959-8138     ISO Abbreviation:  BMJ     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-07-02     Completed Date:  1997-07-02     Revised Date:  2008-11-20    
Medline Journal Info:
Nlm Unique ID:  8900488     Medline TA:  BMJ     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1521-4     Citation Subset:  AIM; IM; J    
Department of Obstetrics and Gynaecology, Aarhus University Hospital, Denmark.
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MeSH Terms
Abortion, Spontaneous / epidemiology
Cross-Sectional Studies
Educational Status
Family Characteristics
India / epidemiology
Infant Mortality
Infant, Newborn
Pregnancy / statistics & numerical data*
Pregnancy Outcome
Pregnancy, Multiple / statistics & numerical data
Reproductive History
Rural Health
Sex Ratio
Socioeconomic Factors

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