A multicentre study of perinatal mortality in Nepal

Area of Science:

• Obstetrics and Gynecology
• Public Health
• Neonatal Medicine

Background:

• Perinatal mortality remains a significant global health challenge, particularly in low-resource settings.
• Understanding urban-rural disparities in perinatal outcomes is crucial for effective public health strategies.

Purpose of the Study:

• To determine urban and rural perinatal mortality rates (PNMRs) in Nepal.
• To identify the primary causes of perinatal mortality in these settings.

Main Methods:

• A prospective survey conducted in two Kathmandu hospitals and two rural districts.
• Inclusion of all perinatal deaths over a one-year period (14,967 total births).
• Cause of death determined via hospital record review or verbal autopsy in rural areas.

Main Results:

• Hospital PNMRs were 48.0 and 23.7 per thousand births.
• Rural PNMRs were substantially higher at 96.2 and 42.5 per thousand births.
• Common causes included perinatal asphyxia, low birthweight, and infection; many deaths were unexplained.

Conclusions:

• High perinatal mortality rates in Nepal reflect challenging childbirth circumstances.
• Scientific introduction of targeted interventions is recommended to reduce mortality.
• Addressing urban-rural disparities is essential for improving neonatal outcomes.