Perinatal mortality audit
S Shrestha1, A Sharma, S Upadhyay
1Department of Pediatrics, Nepal Medical College and Teaching Hospital, Jorpati, Kathmandu, Nepal. sabinajoshi1234@hotmail.com
Insights
Perinatal mortality, a key indicator of healthcare quality, remains high due to factors like low birth weight and preterm birth. Improving neonatal care and antenatal checkups is crucial for reducing these preventable deaths.
Area of Science:
- Obstetrics and Gynecology
- Neonatalogy
- Public Health
Background:
- Perinatal mortality rate serves as a critical indicator of maternal and neonatal healthcare quality.
- Regular perinatal audits are essential for identifying factors contributing to perinatal deaths and implementing targeted interventions.
- Previous studies indicate varying rates of perinatal mortality, necessitating ongoing research and quality improvement initiatives.
Purpose of the Study:
- To analyze perinatal mortality indices in a tertiary care hospital in Nepal.
- To identify common causes and risk factors associated with perinatal deaths.
- To provide recommendations for reducing avoidable perinatal mortality.
Main Methods:
- A retrospective study design was employed, analyzing data from 816 births over a one-year period (April 2007-March 2008).
- Perinatal indices, including stillbirths and early neonatal deaths, were collected and analyzed.
- Causes of death were categorized using Wigglesworth's classification, and risk factors such as birth weight and gestational age were examined.
Main Results:
- The overall perinatal mortality rate was 26.9 per 1000 births.
- Common causes included breech presentation with a stuck head and respiratory distress syndrome in preterm infants.
- Low birth weight (<2500g) and preterm birth (<37 weeks gestation) were significant risk factors, accounting for 76.5% of perinatal deaths and 82% of early neonatal deaths.
Conclusions:
- While the perinatal mortality rate is comparable to other studies, significant proportions of deaths are linked to low birth weight and preterm births.
- There is a critical need to enhance neonatal care services and promote regular antenatal checkups to reduce preventable perinatal and neonatal mortality.
- Targeted interventions focusing on high-risk pregnancies and improved neonatal support are essential for improving outcomes.
Abstract:
Perinatal mortality rate is a sensitive indicator of quality of care provided to women in pregnancy, at and after child birth and to the newborns in the first week of life. Regular perinatal audit would help in identifying all the factors that play a role in causing perinatal deaths and thus help in appropriate interventions to reduce avoidable perinatal deaths. A retrospective study of perinatal indices was conducted among 816 births delivered during the period of 1 year from April 2007 to March 2008 in Nepal Medical College. There were 11 still births and 11 early neonatal deaths. Breech presentation with stucked head and respiratory distress syndrome in preterm babies are the common causes for perinatal mortality. Within the Wigglesworth's classification; group 1, 3 and 4 are the common groups of perinatal death. The 76.5% of perinatal deaths and 100% of early neonatal deaths were low birth weight babies. Similarly 72.5% of perinatal death and 82% of early neonatal death were preterm babies. The perinatal mortality was 26.9/1000 births, comparable to other studies, but still emphasis should be given to upgrade the neonatal care. The efforts should be made for regular antenatal checkups and improvement of neonatal care.
