Perinatal Mortality Magnitude,Determinantsand Causesin WestGojam: Population-Based Nested Case-Control Study
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Date
2012-12
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Addis Ababa University
Abstract
Introduction:The millennium development goal was setto achieve a reduction of childmortality by two thirdsbythe end of 2015. In Ethiopiaeven if a significant reduction inmortality was seen amongthe post neonatal age children yet the death of newborns in theperinatalage category is still high. This studyestimatedtheperinatal mortality rate andidentifieditsdeterminant factors and causes of deathin West Gojam zone,Amhara region.
Methods and materials:Outofthe4158pregnant motherswhowere followed in thecohort of this nested case control study,73 cases and 146 controls wereidentified andinterviewed in three districts of the West Gojam zone, from Feb 2011 to Mar 2012.Wealthindexwas used to estimate the wealth difference amongthestudied families.Factors such asbirth spacing,history of abortion and history of perinatalmortality were included ina multiplebinary logistic regression modelto identify risk factors.Physician review method was used toidentify the causes of death from the verbal autopsy data.
Result:Theperinatal mortality rate was 27.04per 1000 live andstillbirths(95%CI,15.1,38.9).Perinatal mortality was significantly associated with household wealth and family size, those with 2-5 and greater than three family members had a lesser risk for perinatal mortality as compared to those with a family size of only two (AOR=0.04,95%CI 0.01-0.38)and (AOR=0.03,95%CI 0.01-0.27)respectively.Primiparous mothers indicated a greater riskfor perinatal mortality as compared to those who gave birth to five or more children(AOR=7.89,95%CI 1.46-42.77).
In addition women with a previous history of perinatal death and abortion showed a higher risk for perinatal mortality than those who had no history of perinatal mortality or abortion(AOR=14.29,95%CI 5.28 38.67)and(AOR=0.24,95%CI0.1,0.58)respectively.Preterm newborns were more at risk (AOR=17.49,95%CI 1.51,202.78)than the term babies.Twins were also at higher risk for perinatal mortality than the singletons(AOR=5.09,95%CI1.21,21.4). Home delivery was found to protect against perinatal death (AOR=0.05 95%CI0.01,0.26)in comparison to the births that took place in health facilities.
Conclusion:Findings of this study indicated a high perinatal mortality rate and the increase drisk that was associated with selected socio-economic and health service related factors some of which are amenable to change.
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Perinatal Mortality