Risk factors for perinatal mortality at Muhimbili national hospital, Dar es salaam Tanzania:un-matched case control study

Abstract

Background: Perinatal mortality is a sensitive indicator for maternal care. Understanding the risk factors for perinatal mortalityis key to reducing its incidence. There are many risk factors for perinatal mortality that act through complex and interrelated pathways. In-trapartum factors are the main risk factors for perinatal death at MNH, but very little is known on how much a role maternal and socio-demographic factors play in the incidence of perinatal death at MNH. Methodology: This was a hospital based un-matched Case control study conducted at Muhimbili National Hospital between October 2016 and December 2016. Conven-ience,Non-probability method of sampling was employed whereby mothers with perinatal deaths are paired with two others who had live births as controls giving a case to control ratio of 1:2 and sample size of 240. Information including maternal Age, referral status, means of arrival at MNH, maternal level of education, marital status, parity, history of perinatal death, history of abortion, mode of delivery, birthweight of fetus, gestational age of the fetus, LNMP, interval between this birth and the preceding one, time of birth, week date of birth, history of hypertensive disorder, history of diabetes mellitus and number of ANC clinic visits were obtained by interviewing mothers, checking medical records and examining the babies. Bivariate and multivariate analysis were employed to determine the association between maternal socio-demographicfactors and perinatal death. Results :A total of 1025 mothers delivered at MNH during the study period, 107 were perinatal deaths and 918 live births. A sample of 240 mothers was selected of which 80 were cases and 160 were controls. Four factors were found to have significant association with perinatal mortality; Gestation Age<37wks (AOR2.53; CI1.1-5.83: p-0.030), Sponta-neous Vaginal Delivery (AOR3.7; CI 1.017 – 7.21p-0.001), Birth Weight<2500g (AOR2.3; CI1.03–5.25: p-0.04), and maternal Diabetes Mellitus (AOR 3.44; CI1.077–15.98: p-0.036). Conclusion: Our Study found that the risk of perinatal death at MNH was high among Diabetic mothers, Babies born by Spontaneous Vaginal Delivery, babies born before 37 completed weeks, and babies with birth weight <2500g. Maternal Hypertension, baby sex, number of ANC attendance weekend birth, maternal age and birth interval were not sig-nificant.