AETIOLOGY OF PERINATAL MORTALITY- A STUDY IN A RURAL SETTING

Abstract

Background: Each year, an estimated six million perinatal deaths occur worldwide and 98% of them occur in low and middle-income countries. Perinatal deaths are the leading burden of disease among children aged less than five years worldwide. Globally there are 3 major causes of neonatal death: infections (36%), prematurity (28%) and asphyxia (23%). Of the remaining, 7% are due to congenital malformations. Objectives: Analysis of risk factors associated with perinatal mortality and to determine the most common causes of early neonatal deaths. Material and method: The study was carried out at a tertiary care rural hospital of central India. Data were collected on 5,856 births over a one year period. Results: The perinatal mortality rate was 17.07 per 1,000 births; stillbirth rate was 2.39 per 1,000 births; and early neonatal death rate was 15.16 per 1,000 live births. Clinically relevant factors independently associated with perinatal death included: low birth weight, breech presentation, birth asphyxia, sepsis, respiratory distress syndrome, congenital malformations and meconium aspiration syndrome. Over one-half of early neonatal deaths occurred during the first two post natal days, and the most common causes were low birth weight/prematurity (28.80%), asphyxia (13.04%), and congenital malformations (9.23%). Conclusion: Most neonatal deaths occur soon after birth, and nearly three-quarters are caused by low birth weight/prematurity or asphyxia. Neonatal mortality might be reduced by targeting interventions to improve neonatal resuscitation and care of larger preterm infants. Specifically, deaths due to breech presentation, a common risk factor, will be reduced by making available emergency obstetric care. Large number of stillbirths is preventable by regular antenatal check up and institutional delivery.