Factors associated with and causes of perinatal mortality in northeastern Tanzania
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Factors associated with and causes of perinatal mortality in northeastern Tanzania. / Schmiegelow, Christentze; Minja, Daniel; Oesterholt, Mayke; Pehrson, Caroline; Suhrs, Hannah Elena; Boström, Stéphanie; Lemnge, Martha; Magistrado, Pamela; Rasch, Vibeke; Lusingu, John; Theander, Thor G.; Nielsen, Birgitte Bruun.
I: Acta Obstetrica et Gynecologica, Bind 91, Nr. 9, 09.2012, s. 1061-1068.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Factors associated with and causes of perinatal mortality in northeastern Tanzania
AU - Schmiegelow, Christentze
AU - Minja, Daniel
AU - Oesterholt, Mayke
AU - Pehrson, Caroline
AU - Suhrs, Hannah Elena
AU - Boström, Stéphanie
AU - Lemnge, Martha
AU - Magistrado, Pamela
AU - Rasch, Vibeke
AU - Lusingu, John
AU - Theander, Thor G.
AU - Nielsen, Birgitte Bruun
PY - 2012/9
Y1 - 2012/9
N2 - Objective. To identify factors associated with perinatal mortality in northeastern Tanzania. Design. Prospective cohort study. Setting. Northeastern Tanzania. Population. 872 mothers and their newborns. Methods. Pregnant women were screened for factors possibly associated with perinatal mortality, including preeclampsia, small-for-gestational age, preterm delivery, anemia, and health-seeking behavior. Fetal growth was monitored using ultrasound. Finally, the specific causes of the perinatal deaths were evaluated. Main outcome measure. Perinatal mortality. Results. Forty-six deaths occurred. Key factors associated with perinatal mortality were preterm delivery (adjusted odds ratio (OR) 14.47, 95% confidence interval (CI) 3.23-64.86, p < 0.001), small-for-gestational age (adjusted OR 3.54, 95%CI 1.18-10.61, p = 0.02), and maternal anemia (adjusted OR 10.34, 95%CI 1.89-56.52, p = 0.007). Adherence to the antenatal care program (adjusted OR 0.027, 95%CI 0.003-0.26, p = 0.002) protected against perinatal mortality. The cause of death in 43% of cases was attributed to complications related to labor and specifically to intrapartum asphyxia (30%) and neonatal infection (13%). Among the remaining deaths, 27% (7/26) were attributed to preeclampsia and 23% (6/26) to small-for-gestational age. Of these, 54% (14/26) were preterm. Conclusions. Preeclampsia, small-for-gestational age and preterm delivery were key risk factors and causes of perinatal mortality in this area of Tanzania. Maternal anemia was also strongly associated with perinatal mortality. Furthermore, asphyxia accounted for a large proportion of the perinatal deaths. Interventions should target the prevention and handling of these conditions in order to reduce perinatal mortality.
AB - Objective. To identify factors associated with perinatal mortality in northeastern Tanzania. Design. Prospective cohort study. Setting. Northeastern Tanzania. Population. 872 mothers and their newborns. Methods. Pregnant women were screened for factors possibly associated with perinatal mortality, including preeclampsia, small-for-gestational age, preterm delivery, anemia, and health-seeking behavior. Fetal growth was monitored using ultrasound. Finally, the specific causes of the perinatal deaths were evaluated. Main outcome measure. Perinatal mortality. Results. Forty-six deaths occurred. Key factors associated with perinatal mortality were preterm delivery (adjusted odds ratio (OR) 14.47, 95% confidence interval (CI) 3.23-64.86, p < 0.001), small-for-gestational age (adjusted OR 3.54, 95%CI 1.18-10.61, p = 0.02), and maternal anemia (adjusted OR 10.34, 95%CI 1.89-56.52, p = 0.007). Adherence to the antenatal care program (adjusted OR 0.027, 95%CI 0.003-0.26, p = 0.002) protected against perinatal mortality. The cause of death in 43% of cases was attributed to complications related to labor and specifically to intrapartum asphyxia (30%) and neonatal infection (13%). Among the remaining deaths, 27% (7/26) were attributed to preeclampsia and 23% (6/26) to small-for-gestational age. Of these, 54% (14/26) were preterm. Conclusions. Preeclampsia, small-for-gestational age and preterm delivery were key risk factors and causes of perinatal mortality in this area of Tanzania. Maternal anemia was also strongly associated with perinatal mortality. Furthermore, asphyxia accounted for a large proportion of the perinatal deaths. Interventions should target the prevention and handling of these conditions in order to reduce perinatal mortality.
KW - anemia
KW - intrapartum asphyxia
KW - labor and delivery
KW - Perinatal mortality
KW - preeclampsia
KW - preterm birth
KW - small-for-gestational age
UR - http://www.scopus.com/inward/record.url?scp=84865118986&partnerID=8YFLogxK
U2 - 10.1111/j.1600-0412.2012.01478.x
DO - 10.1111/j.1600-0412.2012.01478.x
M3 - Journal article
C2 - 22676243
AN - SCOPUS:84865118986
VL - 91
SP - 1061
EP - 1068
JO - Acta Obstetricia et Gynecologica Scandinavica
JF - Acta Obstetricia et Gynecologica Scandinavica
SN - 0001-6349
IS - 9
ER -
ID: 138138356