Prevalence and Factors Influencing Perinatal Mortality in Rural Mysore, India (original) (raw)
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.
2015
Introduction: Pregnancy, although being considered a physiological state, carries the risk of serious maternal morbidity and at times death. This is due to various complications that may occur during pregnancy, labor or thereafter. Maternal death has serious implications for the family, the society, and the nation. Maternal mortality is universally considered as human development indicator in a country and determines the health status of the people. Method: A retrospective hospital-based study of 65 maternal deaths was conducted over a period of 1-year from January 2014 to December 2014 in respect to maternal age, parity, booking status, residence, referral, socioeconomic class, admission death interval, and cause of death. Result: Over the study period, there were 6277 deliveries, 5761 live births, giving a maternal mortality ratio of 1035 per 100,000 live births. Eclampsia was the leading direct cause and anemia the leading indirect cause. The age group of 20 to 30 years was cruci...
Pattern of Perinatal Mortality Among Deliveries at Holy Family Hospital Rawalpindi
2018
Objective: To determine the pattern of perinatal mortality and its related obstetric risk factors. Methodology: It was a retrospective study carried out from January 2014 to December 2015. All patients delivered in Gynae Unit-II during the study period were included. These women were advised for follow up in OPD one week after delivery. The perinatal deaths including still births and early neonatal deaths (ENND) within 7 days of birth were taken into account. Those with less than 28 weeks of pregnancy were excluded. The data was collected from perinatal mortality excel worksheet, also gathering information of data like age, parity, period of gestation, complications during pregnancy, labor and mode of deliveries. Perinatal data included weight, reported gestational age, sex of baby, Apgar score at birth and possible causes of death. Results: During the period of two years, 20,231 deliveries were conducted. There were 1373 perinatal deaths. 867 were still born while 506 died within seven days of birth. The overall perinatal mortality rate was 67.8/1000 total births and still birth rate 42.9/1000 total births. Main risk factors were mechanical in 21% cases followed by prematurity in 20.3% and hypertensive disorders in 18.8% cases. Antepartum haemorrahge was found in 11.8% while maternal infections / medical problems in 6.5%, congenital anomalies were found in 4.4% and neonatal problems in 15.3%. Conclusion: Strong association of perinatal mortality was noted with lack of antenatal care, preterm gestational age and low birth weight. So, provision of good maternity services including antenatal, intrapartum care and emergency obstetric and neonatal care services at door step of women will help in reducing the perinatal death in developing countries.
Reproductive Health
Background Neonatal mortality causes a substantial proportion of the under-5 mortality in low and middle-income countries (LMIC). Methods We undertook a prospective, population-based research study of pregnant women residing in defined geographic areas in the Karnataka State of India, a research site of the Global Network for Women’s and Children’s Health Research. Study staff collected demographic and health care characteristics on eligible women enrolled with neonatal outcomes obtained at delivery and day 28. Cause of neonatal mortality at day 28 was assigned by algorithm using prospectively defined variables. Results From 2014 to 2018, the neonatal mortality rate was 24.5 per 1,000 live births. The cause of the 28-day neonatal deaths was attributed to prematurity (27.9%), birth asphyxia (25.1%), infection (23.7%) and congenital anomalies (18.4%). Four or more antenatal care (ANC) visits was associated with a lower risk of neonatal death compared to fewer ANC visits. In the adjust...
Perinatal mortality trend and classification of causes at a tertiary care centre of western Nepal
Journal of Kathmandu Medical College
Background: Identifying causes of perinatal death is important to reduce perinatal mortality rate. Objectives: To determine trend of perinatal mortality rate (PMR), ascertain causes, and find out changes in causes of death over period of seven years. Methods: This retrospective study, conducted after ethical approval, included stillbirths and early neonatal deaths at Manipal teaching hospital from April 2014 to April 2021, after 28 weeks of gestation or of foetuses weighing more than 1000 grams. Perinatal mortality rate of each year was calculated. Cause of death was assigned according to International Classification of Disease – Perinatal Mortality classification. Data analysis was done to find out trends and causes of perinatal mortality using SPSS v.21. Frequency and percentages were used to calculate causes of deaths. Results: Perinatal mortality rate decreased from 35.5 to 21.1 per 1000 births over seven years. Antepartum hypoxia (103, 45%) was commonest cause of antepartum dea...