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Factors associated with perinatal deaths in women delivering in a health facility in Malawi

Abstract

Lily C. Kumbani, Johanne Sundby and Jon ├â┬â├ć┬ĺ├â┬é├ő┬ťyvind Odland

The perinatal mortality rate in Malawi is estimated at 40/1,000 births. Annually 6.3 million babies die in the perinatal period globally, with Africa having the highest perinatal mortality rate. This study was conducted to determine perinatal mortality, to identify associated risk factors, and to determine causes of perinatal deaths at Chiradzulu District Hospital, Malawi. The study was designed as a cross sectional study that prospectively reviewed records of 606 births at the health facility. The perinatal mortality rate was 59.9/1,000 births; the stillbirth rate was 36/1,000 births; and the early neonatal death rate was 24/1,000 live births. Of 16 early neonatal deaths, 63% occurred on the day of birth and 19% in next 48 hours. The primary cause (75%) was birth asphyxia. Significant associations with perinatal death included: number of antenatal visits, most in one visit (29.4%); gestation ≤ 31 weeks (47%); prolonged second stage of labour (22%); premature babies with birth weight ≤1499 grams (61%); and severely asphyxiated babies (46%). There is a need to strengthen the care of delivering women for early provision of comprehensive obstetric care. The high perinatal mortality could be reduced by improving health workers’ ability in resuscitation, as well as care of low birth weight babies.

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