Determinants of Perinatal Mortality in Public Hospitals of Iluu Abbaa Boor Oromia Region, South West Ethiopia, 2019: Unmatched Case–Control Study

Abstract

Background: Globally, about 2.5 million children die in the first month after birth; this amounts to 7000 neonatal deaths every day. Almost half of neonatal deaths occur on the first postnatal day, and the vast majority of the rest occurs within the first postnatal week. In Ethiopia, efforts to reduce perinatal mortality did not meet the United Nations Millennium Development Goal (MDG) in 2020. Objective: To identify determinants of perinatal death in public hospitals of Iluu Abbaa Boor Zone, Oromia regional state, Southwest Ethiopia, 2019. Methods: An institution-based, case-control study was employed from March 1 to April 30, 2019 in Iluu Abbaa Boor Zone governmental hospitals. A total of 90 cases were taken consecutively. Four controls were assigned for each case. Maternal and neonatal data were collected by interview using a semi-structured questionnaire and hospital record review. Results: The likelihood of perinatal mortality was 2.8 times greater for those whose mothers did not have regular ANC follow-up (AOR 2.8; 95% CI [1.4-4.8]). The odds of perinatal mortality were 2.8 times higher among newborns of mothers with less than two years birth interval (AOR 2.8; 95% CI [1.8-12.4]). The odds of perinatal mortality were 14.3 times higher among preterm deliveries compared to newborns with term deliveries (AOR 14.3;). Conclusion:In a medical resource-limited region of Ethiopia, not having ANC follow-up, short birth interval, preterm and postterm births, maternal hemoglobin level, use of partograph, were independent determinants of perinatal mortality. Targeting education and medical resources in these areas for women in the reproductive age group could influence regional perinatal mortality.

Determinants of Perinatal Mortality Among Deliveries Attended in Public Hospitals in Hadiya Zone, South Ethiopia

“…There were three times higher odds of perinatal mortality among newborns whose mothers were from rural residences as compared to newborns whose mothers were from urban residences. This finding is supported by studies conducted in Nigeria (20) and Tigray, northern Ethiopia (11). The possible explanation for this might be that urban resident mothers had better wealth, education, sanitation services, and media access for health service utilization.…”

“…This may be due to the fact that a short birth interval increases the risk of obstetric complications that can affect the perinatal outcome. Moreover, long birth spacing enables the maternal body to replenish nutrient stores, accumulate energy, and even decrease economic stress, all of which can lower the risk compared to short birth spacing [14][15][16][17][18][19][20][21][22][23].…”

“…Similar findings were reported by studies conducted in Kenya, Addis Ababa, Tigray, southern Ethiopia, and a meta-analysis done in Ethiopia. The possible reason might be that low birth weight newborns are usually preterm babies, which makes them susceptible to hypothermia, infection, and other health problems, which in turn makes them vulnerable to perinatal death as compared to babies of normal weight [16][17][18][19][20][21][22][23][24][25].…”

Determinants of compliance to iron folate supplementation among pregnant women attending antenatal care in public health facilities of South West Ethiopia: A case‐control study

“…This is because the demand for iron and folic acid increases during pregnancy following the physiological adjustment imposed by pregnancy 4 . If left untreated, it contributes to adverse birth outcomes, including intrauterine foetal growth retardation, preterm delivery, low birth weight, and subsequent maternal and perinatal morbidity and mortality 5,6 . Reducing anaemia is an important component of achieving women's and children's health, and the second global nutrition target for 2025 calls for a 50% reduction of anaemia in women of reproductive age.…”

“… 4 If left untreated, it contributes to adverse birth outcomes, including intrauterine foetal growth retardation, preterm delivery, low birth weight, and subsequent maternal and perinatal morbidity and mortality. 5 , 6 Reducing anaemia is an important component of achieving women's and children's health, and the second global nutrition target for 2025 calls for a 50% reduction of anaemia in women of reproductive age. Thus, to achieve the Global Nutrition Target and prevent these poor health outcomes, the WHO recommends all pregnant women take a standard dose of 60 mg of elemental iron along with 400 μg of folic acid daily for 6 months during pregnancy in areas where there is a moderate prevalence of anaemia and to continue for 3 months after delivery in areas where the prevalence of anaemia is over 40%.…”