Factors associated with and causes of perinatal mortality in northeastern Tanzania

Christentze Schmiegelow; Daniel Minja; Mayke Oesterholt; Caroline Pehrson; Hannah Elena Suhrs; Stéphanie Boström; Martha Lemnge; Pamela Magistrado; Vibeke Rasch; John Lusingu; Thor G. Theander; Birgitte Bruun Nielsen

doi:10.1111/j.1600-0412.2012.01478.x

Factors associated with and causes of perinatal mortality in northeastern Tanzania

Christentze Schmiegelow^*, Daniel Minja, Mayke Oesterholt, Caroline Pehrson, Hannah Elena Suhrs, Stéphanie Boström, Martha Lemnge, Pamela Magistrado, Vibeke Rasch, John Lusingu, Thor G. Theander, Birgitte Bruun Nielsen

^*Corresponding author for this work

36 Citations (Scopus)

Abstract

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.

Original language	English
Journal	Acta Obstetrica et Gynecologica
Volume	91
Issue number	9
Pages (from-to)	1061-1068
Number of pages	8
ISSN	0001-6349
DOIs	https://doi.org/10.1111/j.1600-0412.2012.01478.x
Publication status	Published - Sept 2012

Keywords

anemia
intrapartum asphyxia
labor and delivery
Perinatal mortality
preeclampsia
preterm birth
small-for-gestational age

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@article{f5a588723573486b9650506432ce915a,

title = "Factors associated with and causes of perinatal mortality in northeastern Tanzania",

abstract = "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.",

keywords = "anemia, intrapartum asphyxia, labor and delivery, Perinatal mortality, preeclampsia, preterm birth, small-for-gestational age",

author = "Christentze Schmiegelow and Daniel Minja and Mayke Oesterholt and Caroline Pehrson and Suhrs, {Hannah Elena} and St{\'e}phanie Bostr{\"o}m and Martha Lemnge and Pamela Magistrado and Vibeke Rasch and John Lusingu and Theander, {Thor G.} and Nielsen, {Birgitte Bruun}",

year = "2012",

month = sep,

doi = "10.1111/j.1600-0412.2012.01478.x",

language = "English",

volume = "91",

pages = "1061--1068",

journal = "Acta Obstetrica et Gynecologica",

issn = "0001-6349",

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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

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VL - 91

SP - 1061

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JO - Acta Obstetrica et Gynecologica

JF - Acta Obstetrica et Gynecologica

IS - 9

ER -

Factors associated with and causes of perinatal mortality in northeastern Tanzania

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