Determinants of perinatal mortality among cohorts of pregnant women in three districts of North Showa zone, Oromia Region, Ethiopia: Community based nested case control study

Abstract

BackgroundStatistics indicate that Ethiopia has made remarkable progress in reducing child mortality. It is however estimated that there is high rate of perinatal mortality although there is scarcity of data due to a lack of vital registration in the country. This study was conducted with the purpose of assessing the determinants and causes of perinatal mortality among babies born from cohorts of pregnant women in three selected districts of North Showa Zone, Oromia Region, Ethiopia. The study used community based data, which is believed to provide more representative and reliable information and also aimed to narrow the data gap on perinatal mortality.MethodsA community based nested case control study was conducted among 4438 (cohorts of) pregnant women. The cohort was followed up between March 2011 to December 2012 in three districts of Oromia region, Ethiopia, until delivery. The World Health Organization verbal autopsy questionnaire for neonatal death was used to collect data. A binary logistic regression model was used to identify determinants of perinatal mortality. Causes of deaths were assigned by a pediatrician and neonatologist. Cases are stillbirths and early neonatal death. Control are live births surviving of the perinatal period’ResultA total of 219 newborns (73 cases and 146 controls) were included in the analysis. Perinatal mortality rate was 16.5 per 1000 births. Mothers aged 35 years and above had a higher risk of losing their newborn babies to perinatal deaths than younger mothers [AOR 7.59, (95% CI, 1.91-30.10)]. Babies born to mothers who had a history of neonatal deaths were also more likely to die during the perinatal period than their counterparts [AOR 5.42, (95% CI, 2.27-12.96)]. Preterm births had a higher risk of perinatal death than term babies [AOR 8.58, (95% CI, 2.27-32.38)]. Similarly, male babies were at higher risk than female babies [AOR 5.47, (95% CI, 2.50-11.99)]. Multiple birth babies had a higher chance of dying within the perinatal period than single births [AOR 3.59, (95% CI, 1.20-10.79)]. Home delivery [AOR 0.23, (95% CI, 0.08-0.67)] was found to reduce perinatal deaths. Asphyxia, sepsis and chorioamnionitis were among the leading causes of perinatal deaths.ConclusionThis study reported a lower perinatal mortality rate. The main causes of perinatal death identified were often related to maternal factors. There is still a need for greater focus on these interrelated issues for further intervention.

Determinants Of Perinatal Mortality In Bahir Dar Town Governmental Health Institutions, Northwest, Ethiopia, 2019: Prospective Unmatched Case Control Study

“…Prematurity was one of the strongest determinants of perinatal mortality in this study. The odds of experiencing perinatal mortality were 3.29 fold more likely among premature births compared to those mature births (AOR 3.29, 95%CI;1.86-5.81).This finding was in line with the studies conducted in Gojjam(6),Tigray(16), Oromia (17),Tanzania (18),Zimbabwe(13),Ghana (19) and Kerala, India (20).The study also conducted in Haryana, India (21) showed that odds of perinatal mortality in premature deliveries were about 3.5 times more likely when compared to term deliveries. The other case control study conducted in Brazil(22) also indicated that prematurity was associated with perinatal mortality.…”

Magnitude and trend of perinatal mortality and its relationship with inter-pregnancy interval in Ethiopia: a systematic review and meta-analysis

“…A total of 35 studies included in this review. However, studies included in the meta-analysis were thirty four [ 1 – 3 , 8 , 11 , 12 , 18 – 45 ]. Pregnant women, women attending for labor and delivery service and newborns were study participants considered for data source in primary studies.…”

“…With regard to this, studies identified multiple risk factors for perinatal mortality such as prematurity, low birth weight, previous history of perinatal death, not receiving tetanus toxoid immunization, lack of Iron supplementation etc. [ 1 , 3 , 11 , 12 ]. On the other side, closely spaced pregnancies are hypothesized as one of the risk factors for poor perinatal outcomes [ 13 ].…”

“…However, there were inconsistencies among these studies. Some studies reported that there was relationship [ 1 , 3 ] while others reported no relationship [ 11 , 12 , 14 ]. To come up with evidence based interventions, clarifying the relationship is vital.…”

A Study on Perinatal Mortalities and Its Determinants at A Tertiary Hospital in a Metropolitan City.

“…The perinatal mortality in our study was found to be highest in the age group of 30-35 years (p-value 0.02) despite lesser number of deliveries (than 25-30 years). A recently published nested case control study done Elias Merdassa Roro et al supports the study's observation, viz mothers aged 35 years and above had a higher risk of losing their newborn 10 babies to perinatal deaths than younger mothers. Preterm births had a higher risk of perinatal death than term babies.…”