Perinatal Mortality Magnitude, Determinants and Causes in West Gojam: Population-Based Nested Case-Control Study

Area of Science:

• Public Health
• Neonatal Medicine
• Epidemiology

Background:

• Ethiopia faces a high perinatal mortality rate despite recent reductions in child mortality.
• Understanding the specific determinants and causes of perinatal death is critical for targeted interventions.

Purpose of the Study:

• To assess the magnitude of perinatal mortality in Ethiopia's West Gojam zone.
• To identify independent determinant factors contributing to perinatal death.
• To determine the leading causes of perinatal mortality in the region.

Main Methods:

• A nested case-control study involving 102 cases and 204 controls from a cohort of 4097 mothers.
• Logistic regression models were employed to identify independent risk factors for perinatal mortality.
• The World Health Organization verbal autopsy instrument was used for mortality data collection, with causes assigned by specialists.

Main Results:

• The perinatal mortality rate was 25.1 per 1000 live and stillbirths.
• Risk factors included primiparous mothers (AOR=3.15), previous perinatal death history (AOR=9.55), and preterm birth (AOR=9.44).
• Leading causes were bacterial sepsis, birth asphyxia, and obstructed labor; paradoxically, home delivery showed a protective effect (AOR=0.07).

Conclusions:

• Perinatal mortality rates in West Gojam, Ethiopia, remain a significant public health concern.
• Targeted maternal and child health care services are essential to mitigate the burden of perinatal deaths.
• Further research into the protective effect of home delivery and specific causes is warranted.