Perinatal Mortality and Associated Factors Among Deliveries in Three Municipal Hospitals of Dar Es Salaam, Tanzania

Abstract

Introduction: Perinatal mortality is one of the indicators used to measure the health status of women, newborns and the quality of health provided during antenatal and perinatal period. In Tanzania, Neonatal mortality has remained high (26/ 1000 live births) and it is estimated that more than 1.6 million babies are born every year of which 51,000 die within the first 28days of life. The objective of this study was to determine the causes and factors associated with perinatal deaths among women delivering in the three municipal hospitals in Dar es Salaam, Tanzania. Materials and methods:The study employed an unmatched case control study design and was conducted between November 2010 and February 2011. A pretested and structured data abstraction tool was used to collect information from labour ward registers and the antenatal cards of mothers of the study participants. Data was entered into the computer, cleaned and analyzed using EPI INFO 3.5.1 software. Bivariate analysis was done using the Chi-square test and multiple logistic regression was used to determine the variables which are independent predictors of perinatal mortality. Results: A total of 600 babies (200 cases and 400 controls) were included in the study. Major causes of perinatal mortality included prolonged/ obstructed labour (22%), preeclampsia/ eclampsia (23%), and prematurity accounting for 18.5% of the perinatal deaths. Mothers of the cases were more likely to have a history of previous adverse pregnancy outcome (AOR 2.35,, hypertensive disorder (AOR, 6.67, 95%CI=3.55-12.64), and premature delivery (AOR 12.18,. Conclusion: Pre-eclampsia/ eclampsia, prolonged/ obstructed labour, and prematurity were found to be the main causes of perinatal mortality. Hypertension during pregnancy, a history of previous adverse pregnancy outcome and prematurity, were significantly associated with increased risk of perinatal death. We recommend active screening for risk factors during ANC and timely management of hypertension and obstructed/ prolonged labour.

Predictors of perinatal death in the presence of missing data: A birth registry-based study in northern Tanzania

“…The risk of perinatal death was higher among deliveries from women with hypertensive disorders of pregnancy particularly pre-eclampsia/eclampsia, those with postpartum hemorrhage, abruption placenta, delivered preterm and low birth weight baby, which is similar to other studies [4,12,42,49]. We did not find a significant association between maternal anemia, malaria infection, positive HIV status, systemic infections/sepsis, and placenta previa with an increased risk of perinatal death.…”

“…Perinatal death refers to the number of stillbirths (pregnancy loss that occurs after seven months of gestation and before birth) and early neonatal deaths (deaths of live births within the first seven days of life) [1,2]. Perinatal and maternal health are closely linked; hence perinatal mortality is used as an essential indicator to monitor maternal health status and quality of antenatal, intrapartum, and newborn care [1,[3][4][5]. Globally, more than five million perinatal deaths occur each year [5].…”

“…The risk factors for stillbirths and early neonatal deaths are closely linked, and examining just one or the other is reported to bias the true level of mortality around delivery [2,7]. The risk of perinatal mortality has been associated with preterm birth, shorter birth interval (<24 months), congenital anomalies, previous history of early neonatal death, low birth weight, maternal anemia, placental abruption, ruptured uterus, systemic infections/sepsis, pre-eclampsia, eclampsia, obstetric hemorrhage, having a home delivery, fetal growth restrictions and maternal infections such as syphilis and malaria [3,4,[8][9][10][11][12][13]. As with other adverse maternal outcomes, perinatal deaths recur in subsequent pregnancies [7,14,15].…”

Joint Modeling of Singleton Preterm Birth and Perinatal Death Using Birth Registry Cohort Data in Northern Tanzania

“…Previous studies assessed the independent predictors of preterm birth and perinatal deaths or as the determinants of each other (10)(11)(12)(13)(14)(15)(16)(17). Maternal characteristics and conditions and complications in the current pregnancy increase preterm birth and perinatal death risk (18)(19)(20)(21)(22).…”