Identifying individual and departmental drivers of fetal deaths among Venezuelan and Colombian mothers in Colombia, 2017-2020

Abstract

Objectives: This study aims to examine fetal death rates among Venezuelan migrants and Colombian nationals giving birth in Colombia between 2017 and 2020 and to identify individual and departmental drivers of fetal death among these groups and differences in their risk profiles to highlight key areas of future research and policy intervention. Methods: Drawing upon Colombia’s vital records, existing literature, and other survey data sources, we conducted a descriptive analysis of fetal deaths, live births, and associated department-level characteristics. We further derived a series of logistic regressions to quantify the relationship between various indicators of interest and the likelihood of fetal death among Colombian and Venezuelan women combined and independently. Results: While Venezuelan women had statistically higher rates of fetal deaths than their Colombian counterparts, this disparity was reversed when accounting for various maternal and departmental characteristics. Among both Venezuelan and Colombian women, parity, maternal age, not having reported education data, and being in a department with a higher average number of prenatal visits were associated with higher odds of fetal death, and being in departments with higher proportions of cesarean sections and gross domestic product per capita resulted in a lower likelihood of fetal death. While having any form of health insurance and lower levels of educational attainment were associated with lower odds of fetal death among Colombian women, these associations were found to be insignificant among Venezuelan women. Conclusions: To the best of our knowledge, the present study is the first attempt to examine patterns and drivers of fetal deaths in Colombia across the dimension of migration. Most keenly, we identified a need to lower barriers of access to health insurance for both Colombian women and Venezuelan women as a measure to combat fetal deaths in Colombia. Whether through improvements to the vital registration system or supplemental mixed-methods surveys, future efforts should serve to contextualize the present findings and clarify the mechanisms through which relevant indicators influence the likelihood of fetal deaths within both Colombian and Venezuelan populations.