Understanding determinants of unequal distribution of stillbirth in Tehran, Iran
Amir Almasi-Hashiani (IR), Mahdi Sepidarkish (IR), Simin Pirhadi (IR), Mohammad Chehrazi (IR), Reza Omani Samani (IR), Mohammad Ali Mansournia (IR)
[Almasi-Hashiani] Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran, [Sepidarkish] Royan, [Pirhadi] , [Chehrazi] Royan, [Omani Samani] Royan, [Ali Mansournia] Tehran University of Medical Sciences
Context: Economic inequality in history of stillbirth Objective: To determine the economic inequality in history of stillbirth and understanding determinants of unequal distribution of stillbirth for the first time in Tehran, Iran. Methods: A population-based cross-sectional study was conducted on 5170 pregnancies in Tehran, the capital of Iran since 2015. Principal component analysis was applied to measure the asset-based economic status. Concentration index was used to measure socioeconomic inequality in stillbirth, and then decomposed into its determinants. Results: The Concentration index and its 95% confidence interval for stillbirth was -0.121 (-0.2351361 to -0.001628). Decomposition of the concentration index showed that economic status had the largest contribution (31%) to socioeconomic inequality in stillbirth. Mother education (30%), father occupation (25%) and mother occupation (23%) had the next high positive contribution to measured inequality in stillbirth history, respectively. Conclusions: Stillbirth is unequally distributed among the Iranian women and is mostly concentrated among low economic status people. Although, economic status have most positive contribution and explained about one-third inequality in stillbirth history but remained inequality can be eliminated by managing the other studied determinants such as mother and father education, employment and etc.