Prevalence and Factors Influencing Perinatal Mortality in Rural Mysore, India (original) (raw)
Related papers
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2018
Background: This study helps to assess the burden of perinatal mortality at a tertiary referral hospital in Sikkim known for its hilly terrain which makes health services difficult to access. The aims and objectives were to determine the various causes and risk factors leading to perinatal mortality in order to formulate preventive strategiesMethods: All perinatal deaths over a year between August 2016-2017 were included and analysed in our study.Results: A stillbirth rate of 14 per 1000 total births and early neonatal death rate of 8 per 1000 live births was found in 1855 total births. Complications related to pregnancy like pre-eclampsia (16%), eclampsia (8%), ante-partum haemorrhage (15%) and medical disorders (13%) were major contributors to stillbirths while pre-maturity (53.3%), sepsis (20%), birth asphyxia due to meconium aspiration (13.3%) were notable factors leading to early neonatal deaths. In majority of the cases, factors like poor literacy, low socio-economic status, i...
Risk factors for perinatal mortality in India: a systematic review of observational studies
International Journal Of Community Medicine And Public Health, 2022
Perinatal mortality (PM) is a major public health problem in India and multiple maternal and foetal risk factors have been attributed to high perinatal mortality. This review aimed to systematically summarize the epidemiological literature on maternal and fetal risk factors for PM including those for still birth, intrauterine deaths; early neonatal mortality; early neonatal deaths in India. This systematic review was compliant with preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. We searched for peer-reviewed articles from three electronic bibliographic databases: MEDLINE, Embase, Google Scholar published between 1 January 2000 and 31 March 2019 that reported the risk factors of perinatal mortality in India. Observational studies (cross sectional, casecontrol and COHORT Studies). Eighteen articles were included in this review. The major risk factors identified for perinatal mortality in India were maternal age, parity, higher birth order and maternal anemia. Complications during pregnancy like ante partum hemorrhage, preeclampsia, obstructed labor, preterm labor and fetal factors like gestational age and low birth weight were documented as risk factors for perinatal deaths. Strengthening national health programs and targeted interventions for both antenatal and institutional care is required to bring down perinatal deaths in India.
Perinatal mortality and risk factors in Ludhiana: a population-based prospective cohort study
The study cohort comprised 1,551 pregnant women detected and followed up till 7 days after the termination of the pregnancy, during the 2-year period from January 2006 to December 2007. Out of the 1,551 pregnant women identified, 80 suffered an abortion while 40 were lost to follow-up, hence 1,431 pregnant women from the cohort completed the study. Out of 1,431 total births, 33 were stillbirths. Of the 1,398 live-born, 40 suffered early neonatal (first week) deaths, thereby totalling 73 perinatal deaths. Hence, the PNMR was 51/1000 total births. Mother's age < 20 years, illiteracy, lack of regular paid employment, nuclear families, urban slum-dwellers and poverty are observed to be important socioeconomic determinants of perinatal mortality. Multigravidity and maternal anaemia are significant antenatal risk factors, while spacing < 3 years and lack of antenatal care including tetanus and anaemia prophylaxis also carry a higher risk of perinatal mortality. LBW, gestational age < 37 weeks and delivery conducted by untrained hands are observed to be significant intra-natal risk factors. Promoting female literacy, late marriages, spacing and limitation of childbirths, improving maternal nutrition and providing universal antenatal , intra-natal and post-natal care are priority actions that can reduce perinatal mortality. But here, what is needed is adoption of a "risk approach" where the most vulnerable, the poor and the marginalised are targeted for priority care.
PERINATAL MORTALITY AND ITS RISK FACTORS IN LUDHIANA:
A prospective, cohort study was carried out to determine the perinatal mortality rate (PNMR) among the population of Ludhiana in Punjab. The study population comprised 20,000 urban, 20,000 urban slum and 10,000 rural residents of the field practice areas of the Department of Community Medicine, Christian Medical College, Ludhiana (CMCL). The study cohort comprised 1,551 pregnant women detected and followed up till 7 days after the termination of the pregnancy, during the 2-year period from January 2006 to December 2007. Out of the 1,551pregnant women identified, 80 suffered an abortion while 40 were lost to follow-up, hence 1,431 pregnant women from the cohort completed the study. Out of 1,431 total births, 33 were stillbirths. Of the 1,398 live-born, 40 suffered early neonatal (first week) deaths, thereby totalling 73 perinatal deaths. Hence, the PNMR was 51/1000 total births. Mother's age < 20 years, illiteracy, lack of regular paid employment, nuclear families, urban slum-dwellers and poverty are observed to be important socio-economic determinants of perinatal mortality. Multigravidity and maternal anaemia are significant ante-natal risk factors, while spacing <3 years and lack of ante-natal care including tetanus and anaemia prophylaxis also carry a higher risk of perinatal mortality. LBW, gestational age < 37 weeks and delivery conducted by untrained hands are observed to be significant intra-natal risk factors. Promoting female literacy, late marriages, spacing and limitation of childbirths, improving maternal nutrition and providing universal ante-natal, intra-natal and post-natal care are priority actions that can reduce perinatal mortality. But here, what is needed is adoption of a “risk approach” where the most vulnerable, the poor and the marginalised are targeted for priority care. Key Words : Perinatal Mortality, Risk Factors, Prospective Cohort Study.
Perinatal Mortality and Related Obstetric Risk Factors at a Tertiary Care Hospital of Hyderabad
2008
OBJECTIVE: To determine perinatal mortality rate and its related obstetric risk factors in our setup. DESIGN: Observational study. SETTING: Department of Obstetrics and Gynaecology (Unit-I), Liaquat University Hospital Hyderabad, from January to December 2006. PATIENTS AND METHODS: All perinatal deaths including stillbirths (SBs) and early neonatal deaths (ENNDs) within 0-7 days of birth after 24 weeks of gestation were studied during the study period, while Pregnancies <24 weeks of gestation were excluded from the study. The relevant information was collected through a pre-designed proforma which contained variables including maternal demographics, obstetric risk factors and other details. RESULTS: A total number of 2224 deliveries were analysed for perinatal mortality. Out of these, there were 224 perinatal deaths giving a PNMR of 100.7/1000 births. There were 196 SBs and 28 ENNDs. Among these, 88% women were unbooked. Commonest risk factors was antepartum haemorrhage (27.67%), followed by hypertensive disorders of pregnancy (23.21%) and mechanical factors affecting labour (14.28%). Congenital abnormalities were found in 9.8% of PNDs while maternal medical disorders were seen in 6.25% cases. In 3.5% cases, chorioamnionitis/ neonatal septicaemia was the underlying cause and multiple pregnancies were seen in only 02 (0.89%) cases. However, in 32 (14.28%) cases, no cause was found. CONCLUSION: The high perinatal mortality rate in present study is comparable to the figures from other institutions. Main reason being lack of antenatal and pre-pregnancy care where from almost all obstetric risk factors can be picked up and treated / prevented.
Perinatal mortality-incidence and effect of various maternal factors, Part I
Indian journal of pediatrics
Of 12,716 consecutive births, over a period of eleven years, perinatal mortality rate was 80,7, still birth rate 41.4 and early neonatal death rate 39.3. Perinatal mortality was very high in association with previous pregnancy wastages, obstetrical complications like toxemia and antepar: tum hemorrhage, acute infection and chronic illnesses during pregnancy, abnormal presentation, prolonged sedation and anesthesia. Teenage and elderly mothers, primi and grandmultipara, mothers with anemia and A or 0 blood group and consangunity also had liigh perinatal losses.
Rural and Remote Health, 2015
Introduction: Perinatal mortality rate has been regarded as an indicator of the quality of prenatal, obstetric and neonatal care in an area, which also reflects the maternal health and socioeconomic environment. The objective of the current study was to identify causes and risk factors for perinatal deaths among the tribal population in Jawadhi Hills, Tamil Nadu, southern India. Methods: A community-based case control study design was used, where a case was a perinatal death and controls were from a sampling frame of all children who were born alive in the same area ±7 days from the day of birth of the case. The WHO Standard International Verbal Autopsy form was used to arrive at the cause of death. Univariate and multivariate analyses for factors associated with perinatal deaths were done. Results: A total of 40 cases, including 22 early neonatal deaths and 18 stillbirths, and 110 controls were included in the study. Among the perinatal deaths, 40% were born prematurely. Sepsis (17.5%) and birth asphyxias (12.5%) were the major causes of deaths. In the final logistic regression model, parity ≥4 (odds ratio [OR] 5.75 [95% confidence interval (CI) 1.88-17.54]), preterm births (OR 5.62 [95% CI 2.12-16.68]) and time to reach the nearest health facility more than two hours (OR 2.51 [95% CI 1.086.73]) were significantly associated with the perinatal deaths. Conclusions: Prematurity, poor accessibility and a high parity were significantly associated with perinatal deaths in the tribal population of Jawadhi Hills.
Perinatal Mortality in South Asia: Systematic Review of Observational Studies
International journal of environmental research and public health, 2018
This study aimed to systematically review observational studies on perinatal mortality in South Asia. This review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Five computerized bibliographic databases: MEDLINE, CINAHL, Embase, PsycINFO, and Scopus were searched for published studies which reported factors associated with perinatal mortality in South Asia from 1 January 2000 to 20 March 2018. All relevant observational studies (cohort, cross-sectional and case-control) were reviewed. Fourteen studies met the selection criteria. The most common factors associated with perinatal mortality were: low socioeconomic status, lack of quality health-care services, pregnancy/obstetric complications and lack of antenatal care. Interventions to reduce perinatal mortality in the South Asia should focus on the provision of adequate antenatal care and quality healthcare services which are accessible to women of low socioecono...
Journal of South Asian Federation of Obstetrics and Gynaecology
Aim: To analyze the perinatal mortality rate in a tertiary care center. Background: To identify possibly responsible maternal risk factors in a tertiary care hospital in developing country. Methodology: Data of perinatal deaths from 1 January 2019 to 31 December 2019 was collected from monthly perinatal mortality records. All patients with fetal death after 28 weeks of pregnancy till the period of 7 days after neonatal birth were included in this study. Results: The study conducted at our hospital aimed at investigating the causes of perinatal mortality and related maternal risk factors resulting in perinatal mortality. The total confinement number was 6,688; among these, the number of fresh stillbirth was 155, macerated stillbirth was 137, and neonatal death was 24. Among the 316 perinatal deaths, 241 deaths (69.6%) were noted before 37 weeks of pregnancy and 75 deaths were noted after 37 weeks of pregnancy (15.18%). Out of 316 deaths, 100 deaths observed in patients induced for labor. Of these, 100 neonates, 88 delivered vaginally and 12 neonates delivered by cesarean section. The 69 neonates (21.83%) deaths observed in the patients who had undergone cesarean section. A total of 33 (10.44%) deaths resulted due to birth asphyxia, 72 (22.78%) deaths observed due to preterm delivery, 22 (6.96%) deaths were due to congenital anomalies. Preterm was one of the most important risk factors observed in 72 (22.78%) women with perinatal deaths. Conclusion: Prematurity, low birth weight (LBW), no proper wrapping of newborns, and no guidance and proper training to mothers were significantly associated with higher probability of neonatal mortality.