Factors associated with perinatal mortality in Hai district,tanzania

Abstract

community and it is also highly amenable to interventions. This community based retrospective case-control study was done to determine cultural, environmental, maternal and foetal risk factors for perinatal mortality in Hai district. A total of 350 mothers were studied, 121 of whom had perinatal deaths, termed as cases and 229 with no perinatal deaths, termed as controls. Socio-demographic characteristics in both groups were similar, 14(11 %) of the cases and 18(7.9%) of the controls were teenagers. Family socio-economic status was also similar. Poor labour outcome accounted for 47(49.6%) of the deaths and prematurity another 12(19.15%). Most of the deaths 69(68%) occurred during the cold season. Duration of labour was significantly longer in cases than in controls (P=0.0019). Thirty one (25%) of cases and 28(12.2%) of controls delivered at home or on their way to the health units (P = 0.002). However, 108 (89.3%) of the cases and 203 (88.6%) of the controls were at an hour walking distance to their nearest health units. Deliveries of 27(21.7%) of the cases as compared to 26(11.4%) of the controls were done by untrained personnel (P = 0.01). Antenatal services utilisation was poorer in mothers who had lost their babies. Nine (7.4%) of the cases had not booked for antenatal services at all. This contrasts sharply with a figure of 2(0.82%) for the controls (P = 0.0016). Twenty four (21.4%) of the cases and 15(6.6%) of the controls booked during the third trimester (P =0.0001). Most of the cases, 89(79.5%) and 182 (79.9%) of the controls had not been investigated.

III None of the three basic investigations were done in any of the study cases, and they were done in only two of the controls. Basic routine antenatal examination was done only in 76 (21.2%) of all mothers in the study; 17 (15.2%) of cases and 4 (1.7%)of the controls had not being examined at all (P = 0.0018). Twenty seven of the cases (24.1%) and 24 (10.5%) of the controls did not receive any of the routinely given medications which are chloroquine, T.T, ferrous sulphate and folic acid ( P=0.002 ) Mothers of 87 (71.9%) of the cases and 123 (53.7%) of the controls had severe and extreme physical exertion during pregnancy (P = 0.0014). Female genital mutilation was done in 51 (42.1 %) of the cases and 105 (45.9%) of the controls (P=0.5). In conclusion, prolonged labour, being attended by untrained person during delivery, few antenatal visits, delayed surgical intervention, severe physical exertion, and place of delivery other than health units were associated with an inreased risk of perinatal mortality.