[Perinatal hospital mortality: its relationship with prenatal care quality]

Our aim was to analyze infant mortality at the Mexican Institute of Social Security (IMSS) North Veracruz, Mexico, Delegation from the perspective of prenatal care quality.

We performed a retrospective case-control study and included all cases of perinatal mortality at the IMSS at North Veracruz from July 1 to December 31, 2003. There were two controls per case matched by gender and date of birth. Prenatal care quality was evaluated by a specifically developed questionnaire.

A total of 53 cases were used for the final analysis. Maternal age was similar between cases and controls (p = 0.814). There were fewer prenatal appointments (p = 0.0001), fewer test performed [blood test (p = 0.0001) and urine test (p = 0.004)], higher obstetric risk (p = 0.004), and fewer obstetric ultrasound imaging studies developed (p = 0.022) in cases of perinatal mortality vs. controls. Main variables related with perinatal mortality were the following: absent of blood test (odds ratio [OR] 4.7, 95% confidence interval [Cl 95%] 2.2-9.9, p = 0.0001); urine test (OR 4.4, CI 95% 1.5-12.6, p = 0.004), and obstetric ultrasound studies (OR 2.3, Cl 95%, 1.1-4.8, p = 0.022), and having fewer than five prenatal appointments (OR 2.2, Cl 95% 1.1-4.4, p = 0.018).

There is evidence of inadequate prenatal care quality in cases of hospital perinatal mortality in Veracruz. Absence of obstetric ultrasound imaging studies and blood tests during prenatal care increases the risk of perinatal mortality 2-4 times.