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Are deaths due to prematurity avoidable in developing countries?

R C Pattinson1

  • 1MRC Maternal and Infant Health Care Strategies Research Unit, University of Pretoria, South Africa. rcpattin@kalafong.up.ac.za

Tropical Doctor
|February 13, 2004
PubMed
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Reducing perinatal mortality from preterm birth in South Africa requires improved neonatal care adaptation to resource limitations, as most spontaneous preterm births are unavoidable. Key factors include timely help during labor and access to facilities.

Area of Science:

  • Obstetrics and Gynecology
  • Neonatal Medicine
  • Public Health

Background:

  • Spontaneous preterm delivery is a significant contributor to perinatal mortality.
  • Addressing preventable factors is crucial for improving neonatal outcomes.

Purpose of the Study:

  • To assess the potential for reducing perinatal mortality rate (PNMR) associated with spontaneous preterm delivery in South Africa.
  • To identify avoidable factors contributing to perinatal deaths in spontaneous preterm births.

Main Methods:

  • Analysis of data from 44 Perinatal Problem Identification Program sentinel sites in South Africa.
  • Review of 3045 perinatal deaths among 78,343 births (> or = 1000 g) to determine primary causes and identify substandard care.

Main Results:

Related Experiment Videos

  • Spontaneous preterm labor was the primary obstetric cause of death in 17% of perinatal deaths (PNMR 7.48/1000 births).
  • Common avoidable factors included delayed help-seeking during labor (14.7%), lack of neonatal facilities (10.0%), and inadequate transport (7.3%).
  • Few deaths were linked to poor antenatal or intrapartum management; most spontaneous preterm births were unavoidable within health institutions.

Conclusions:

  • Prevention of deaths from prematurity outside metropolitan areas depends on adapting neonatal care to resource constraints.
  • Improving access to neonatal facilities and transport are critical interventions.
  • Focusing on resource-adapted neonatal care is key to reducing mortality in spontaneous preterm births.