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Perinatal mortality in Matlab, Bangladesh: a community-based study
V Fauveau1, B Wojtyniak, G Mostafa
1International Centre for Diarrhoeal Disease Research, (ICDDR,B), Dhaka, Bangladesh.
Insights
This study monitored perinatal deaths in rural Bangladesh from 1979-1986. An intensive Family Planning and Health Services program significantly reduced perinatal mortality, highlighting the importance of integrated maternity care.
Area of Science:
- Public Health
- Demography
- Maternal and Child Health
Background:
- Perinatal mortality, encompassing stillbirths and early neonatal deaths, remains a critical global health challenge.
- Understanding demographic trends and determinants of perinatal mortality is essential for targeted interventions.
Purpose of the Study:
- To monitor perinatal death rates in a rural Bangladeshi population over an eight-year period.
- To investigate the impact of an intensive Family Planning and Health Services program on perinatal mortality.
- To identify major causes and maternal determinants of perinatal deaths.
Main Methods:
- Longitudinal monitoring of perinatal deaths (stillbirths and first-week deaths) in a population of 196,000.
- Comparison of mortality trends between an intervention area with a Family Planning and Health Services program and an adjacent control area.
- Analysis of perinatal mortality rates, sex differentials, and identified causes and maternal determinants.
Main Results:
- The overall perinatal mortality rate was 75 per 1000 total births, with a 13% higher rate in males.
- Stillbirth and early neonatal mortality rates were 37 and 38 per 1000 total births, respectively.
- Significant decline in perinatal mortality observed in the intervention area, but not in the control area.
Conclusions:
- Intensive Family Planning and Health Services programs appear to positively impact perinatal mortality.
- Integration of robust maternity care into primary healthcare strategies is crucial for reducing perinatal mortality.
- Further research into specific program components and maternal determinants is warranted.
Abstract:
Perinatal deaths, comprising stillbirths and deaths during the first week of life, were monitored over the eight-year period 1979 to 1986 in a rural Bangladeshi population of 196,000. The perinatal mortality rate was 75 per 1000 total births. The rate was 13% higher in males than females. Stillbirth and early neonatal mortality rates were 37 and 38 per 1000 total births, respectively. The major causes of perinatal deaths are presented, as well as some of the maternal determinants. During the period under study, perinatal mortality declined regularly and significantly over time in an area covered by an intensive Family Planning and Health Services programme, but not in the adjacent control area. This raises the issue of the impact of such a programme upon perinatal mortality, and the need to include a strong maternity care component into primary healthcare strategies if further reductions of perinatal mortality are to be achieved.