Factors associated with and causes of perinatal mortality in northeastern Tanzania

Research output: Contribution to journalJournal articleResearchpeer-review

Christentze Schmiegelow, Daniel Minja, Mayke Oesterholt, Caroline Pehrson, Hannah Elena Suhrs, Stéphanie Boström, Martha Lemnge, Pamela Magistrado, Vibeke Rasch, John Lusingu, Thor G. Theander, Birgitte Bruun Nielsen

Objective. To identify factors associated with perinatal mortality in northeastern Tanzania. Design. Prospective cohort study. Setting. Northeastern Tanzania. Population. 872 mothers and their newborns. Methods. Pregnant women were screened for factors possibly associated with perinatal mortality, including preeclampsia, small-for-gestational age, preterm delivery, anemia, and health-seeking behavior. Fetal growth was monitored using ultrasound. Finally, the specific causes of the perinatal deaths were evaluated. Main outcome measure. Perinatal mortality. Results. Forty-six deaths occurred. Key factors associated with perinatal mortality were preterm delivery (adjusted odds ratio (OR) 14.47, 95% confidence interval (CI) 3.23-64.86, p < 0.001), small-for-gestational age (adjusted OR 3.54, 95%CI 1.18-10.61, p = 0.02), and maternal anemia (adjusted OR 10.34, 95%CI 1.89-56.52, p = 0.007). Adherence to the antenatal care program (adjusted OR 0.027, 95%CI 0.003-0.26, p = 0.002) protected against perinatal mortality. The cause of death in 43% of cases was attributed to complications related to labor and specifically to intrapartum asphyxia (30%) and neonatal infection (13%). Among the remaining deaths, 27% (7/26) were attributed to preeclampsia and 23% (6/26) to small-for-gestational age. Of these, 54% (14/26) were preterm. Conclusions. Preeclampsia, small-for-gestational age and preterm delivery were key risk factors and causes of perinatal mortality in this area of Tanzania. Maternal anemia was also strongly associated with perinatal mortality. Furthermore, asphyxia accounted for a large proportion of the perinatal deaths. Interventions should target the prevention and handling of these conditions in order to reduce perinatal mortality.

Original languageEnglish
JournalActa Obstetrica et Gynecologica
Volume91
Issue number9
Pages (from-to)1061-1068
Number of pages8
ISSN0001-6349
DOIs
Publication statusPublished - Sep 2012

    Research areas

  • anemia, intrapartum asphyxia, labor and delivery, Perinatal mortality, preeclampsia, preterm birth, small-for-gestational age

ID: 138138356