Perinatal mortality--report of a hospital based study

Area of Science:

• Obstetrics and Gynecology
• Neonatalogy
• Public Health

Background:

• Perinatal mortality remains a significant global health challenge.
• Understanding risk factors and causes of perinatal death is crucial for intervention.
• Previous studies highlight various maternal and fetal factors influencing perinatal outcomes.

Purpose of the Study:

• To determine the perinatal mortality rate (PNMR) in a large cohort.
• To identify key maternal and fetal risk factors associated with perinatal mortality.
• To investigate the primary causes of perinatal death through necropsy.

Main Methods:

• Retrospective analysis of 27,394 consecutive births.
• Statistical evaluation of perinatal mortality rate (PNMR) in relation to maternal age, parity, and obstetric history.
• Examination of birth weight, necropsy findings, and assigned causes of death.

Main Results:

• The overall PNMR was 75.6 per 1000 births (40.0 neonatal deaths, 35.6 fetal losses).
• Higher PNMR was observed at extremes of maternal age, parity five and above, and with prior pregnancy loss.
• Low birth weight (<2500g) affected one-third of infants; a birth weight cutoff of 2000g identified high-risk infants.
• Common causes of death included asphyxia (24.33%), pulmonary conditions (20.02%), congenital malformations (13.6%), and infections (6.19%).
• A significant proportion of deaths had undetermined causes (22.12% at necropsy, 26.76% clinico-pathologically).

Conclusions:

• Perinatal mortality is significantly influenced by maternal age, parity, and obstetric history.
• Birth weight is a critical indicator, with infants under 2000g requiring special attention.
• Preventable causes like asphyxia and low birth weight underscore the need for enhanced antenatal and intranatal care, and improved maternal nutrition.