Causes of perinatal mortality and associated maternal factors in a tertiary referral hospital of Gandaki province of Nepal: a cross-sectional study from a hospital-based surveillance.
Antenatal care
Mortality surveillance
Perinatal mortality
Preterm labor
Stillbirth
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
24 Mar 2022
24 Mar 2022
Historique:
received:
16
08
2021
accepted:
21
03
2022
entrez:
25
3
2022
pubmed:
26
3
2022
medline:
5
4
2022
Statut:
epublish
Résumé
Perinatal and neonatal death rates have decreased recently but it still poses a major challenge to the health system of Nepal. The study was conducted to explore the pattern and causes of perinatal deaths. This was a descriptive cross-sectional study conducted from September 2020 to June 2021 using the data of perinatal mortality of three years from June 15, 2017, to June 14, 2020. The demographic parameters of the mother consisted of maternal age, place of residence, ethnicity, antenatal care, the number of antenatal visits, gravida, gestational weeks, and the mode of delivery. The causes of death were categorized into fetal and early neonatal deaths. Fetal deaths were further classified as macerated stillbirth and fresh stillbirth. The attribution of the causes of deaths to fetal/neonatal and maternal conditions was done as per the guidelines of the WHO application of ICD-10 to deaths during the perinatal period. There were a total of 145 perinatal deaths from 144 mothers among which 92 (63.5%) were males. Ten mothers (6.9%) had not sought even single antenatal care, whereas 32 (22.9%) had visited for antenatal care one to three times. At least one cause of death was identified in 114 (78.6%) and remained unknown in 31(21.4%) cases. Among the 28 cases of macerated stillbirths, the cause of death was not identified in 14 (50%), whereas preterm labor was attributed to the cause of death in four (14.3%). In 53 of the fresh stillbirths, intrapartum hypoxia was identified as the cause of death in 20 (37.7%) cases, preterm labor in nine (17%), and was left unknown in 15 (28.3%) cases. Among the 64 early neonatal deaths, prematurity was attributed as the cause of death in 32 (50%) cases, birth asphyxia, and infections each in 11 (17.2%). The perinatal mortality surveillance system identified the causes of death in most of the cases in our observation. Prematurity was identified as the commonest cause of early neonatal deaths and preterm labor was the commonest cause responsible for perinatal deaths overall. The perinatal deaths should be investigated to establish exact causes of deaths which can be useful to develop prevention strategies.
Sections du résumé
BACKGROUND
BACKGROUND
Perinatal and neonatal death rates have decreased recently but it still poses a major challenge to the health system of Nepal. The study was conducted to explore the pattern and causes of perinatal deaths.
METHODS
METHODS
This was a descriptive cross-sectional study conducted from September 2020 to June 2021 using the data of perinatal mortality of three years from June 15, 2017, to June 14, 2020. The demographic parameters of the mother consisted of maternal age, place of residence, ethnicity, antenatal care, the number of antenatal visits, gravida, gestational weeks, and the mode of delivery. The causes of death were categorized into fetal and early neonatal deaths. Fetal deaths were further classified as macerated stillbirth and fresh stillbirth. The attribution of the causes of deaths to fetal/neonatal and maternal conditions was done as per the guidelines of the WHO application of ICD-10 to deaths during the perinatal period.
RESULTS
RESULTS
There were a total of 145 perinatal deaths from 144 mothers among which 92 (63.5%) were males. Ten mothers (6.9%) had not sought even single antenatal care, whereas 32 (22.9%) had visited for antenatal care one to three times. At least one cause of death was identified in 114 (78.6%) and remained unknown in 31(21.4%) cases. Among the 28 cases of macerated stillbirths, the cause of death was not identified in 14 (50%), whereas preterm labor was attributed to the cause of death in four (14.3%). In 53 of the fresh stillbirths, intrapartum hypoxia was identified as the cause of death in 20 (37.7%) cases, preterm labor in nine (17%), and was left unknown in 15 (28.3%) cases. Among the 64 early neonatal deaths, prematurity was attributed as the cause of death in 32 (50%) cases, birth asphyxia, and infections each in 11 (17.2%).
CONCLUSIONS
CONCLUSIONS
The perinatal mortality surveillance system identified the causes of death in most of the cases in our observation. Prematurity was identified as the commonest cause of early neonatal deaths and preterm labor was the commonest cause responsible for perinatal deaths overall. The perinatal deaths should be investigated to establish exact causes of deaths which can be useful to develop prevention strategies.
Identifiants
pubmed: 35331187
doi: 10.1186/s12884-022-04596-0
pii: 10.1186/s12884-022-04596-0
pmc: PMC8952269
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
245Informations de copyright
© 2022. The Author(s).
Références
Lancet Glob Health. 2016 Feb;4(2):e98-e108
pubmed: 26795602
Glob Health Action. 2020 Dec 31;13(1):1792682
pubmed: 32713325
Aust N Z J Obstet Gynaecol. 2020 Feb;60(1):70-75
pubmed: 31134624
Lancet Glob Health. 2013 Sep;1(3):e125-6
pubmed: 25104253
BMC Pregnancy Childbirth. 2015;15 Suppl 2:S9
pubmed: 26391558
Natl Vital Stat Rep. 2015 Dec;64(12):1-64
pubmed: 26727629
Am Fam Physician. 2017 Mar 15;95(6):366-372
pubmed: 28318214
Int J Epidemiol. 2019 Apr 01;48(Suppl 1):i54-i62
pubmed: 30883653
Obstet Gynecol. 2008 Jul;112(1):29-34
pubmed: 18591304
Paediatr Perinat Epidemiol. 1995 Jan;9(1):74-89
pubmed: 7724415
BMC Health Serv Res. 2020 Sep 4;20(1):833
pubmed: 32887603
BMC Pregnancy Childbirth. 2014 May 12;14:165
pubmed: 24884759
Community Genet. 2002;5(1):61-9
pubmed: 14960901
Kathmandu Univ Med J (KUMJ). 2010 Jan-Mar;8(29):62-72
pubmed: 21209510
Int J Environ Res Public Health. 2020 May 14;17(10):
pubmed: 32422977
Reprod Health. 2019 May 10;16(1):53
pubmed: 31077244
PLoS One. 2013;8(1):e54865
pubmed: 23372783
JNMA J Nepal Med Assoc. 2019 May-Jun;57(217):164-167
pubmed: 31477955
BMC Pregnancy Childbirth. 2019 Mar 11;19(1):88
pubmed: 30866847
Lancet Glob Health. 2020 Jul;8(7):e909-e919
pubmed: 32562647
BMC Pediatr. 2015 Oct 05;15:144
pubmed: 26438252