Perinatal Mortality Magnitude, Determinants and Causes in 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 set to achieve a reduction of child mortality by two thirds by the end of 2015. In Ethiopia even if a significant reduction in mortality was seen among the post neonatal age children yet the death of newborns in the perinatal age category is still high. This study estimated the perinatal mortality rate and identified its determinant factors and causes of death in West Gojam zone ,Amhara region.
Methods and materials:Outofthe4158pregnant mothers who were followed in the cohort of this nested case control study,73 cases and 146 controls were identified and interviewed in three districts of the West Gojam zone, from Feb 2011 to Mar 2012.Wealthindexwas used to estimate the wealth difference among the studied families. Factors such as birth spacing, history of abortion and history of perinatal mortality were included in a multiple binary logistic regression model to identify risk factors. Physician review method was used to identify the causes of death from the verbal autopsy data.
Result: The perinatal mortality rate was 27.04per 1000 live and still births (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 risk for 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 increased risk 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