Perinatal Mortality in Eastern Uganda: A Community Based Prospective Cohort Study
Open Access
- 9 May 2011
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 6 (5), e19674
- https://doi.org/10.1371/journal.pone.0019674
Abstract
To achieve a child mortality reduction according to millennium development goal 4, it is necessary to considerably reduce neonatal mortality. We report stillbirth and early neonatal mortality risks as well as determinants of perinatal mortality in Eastern Uganda. A community-based prospective cohort study was conducted between 2006 and 2008. A total of 835 pregnant women were followed up for pregnancy outcome and survival of their children until 7 days after delivery. Mother's residence, age, parity, bed net use and whether delivery took place at home were included in multivariable regression analyses to identify risk factors for perinatal death. The stillbirth risk was 19 per 1,000 pregnancies and the early neonatal death risk 22 per 1,000 live births. Overall, the perinatal mortality risk was 41 [95%CI: 27, 54] per 1,000 pregnancies. Of the deaths, 47% followed complicated deliveries and 24% preterm births. Perinatal mortality was 63/1,000 pregnancies among teenage mothers, 76/1,000 pregnancies among nulliparous women and 61/1,000 pregnancies among women delivering at home who, after controlling for potential confounders, had a 3.7 (95%CI: 1.8, 7.4) times higher perinatal mortality than women who gave birth in a health facility. This association was considerably stronger among nulliparous women [RR 8.0 (95%CI: 2.9, 21.6)] than among women with a previous live birth [RR 1.8 (95%CI: 0.7, 4.5)]. All perinatal deaths occurred among women who did not sleep under a mosquito net. Women living in urban slums had a higher risk of losing their babies than those in rural areas [RR: 2.7 (95%CI: 1.4, 5.3)]. Our findings strengthen arguments for ensuring that pregnant women have access to and use adequate delivery facilities and bed nets.Keywords
This publication has 14 references indexed in Scilit:
- Global, regional, and national causes of child mortality in 2008: a systematic analysisThe Lancet, 2010
- Global report on preterm birth and stillbirth (3 of 7): evidence for effectiveness of interventionsBMC Pregnancy and Childbirth, 2010
- Reducing stillbirths: prevention and management of medical disorders and infections during pregnancyBMC Pregnancy and Childbirth, 2009
- 3.2 million stillbirths: epidemiology and overview of the evidence reviewBMC Pregnancy and Childbirth, 2009
- Perinatal Mortality in Developing CountriesNew England Journal of Medicine, 2005
- 4 million neonatal deaths: When? Where? Why?The Lancet, 2005
- REDUCTION OF MALARIA DURING PREGNANCY BY PERMETHRIN-TREATED BED NETS IN AN AREA OF INTENSE PERENNIAL MALARIA TRANSMISSION IN WESTERN KENYAThe American Journal of Tropical Medicine and Hygiene, 2003
- Levels and risk factors for perinatal mortality in Ahmedabad, India.1991
- Machakos Project Studies: agents affecting health of mother and child in a rural area of Kenya. XVI. The outcome of pregnancy.1979
- Malaria, anaemia and pregnancyPathogens and Global Health, 1969