Perinatal mortality audit in a tertiary healthcare center in Uttar Pradesh: a retrospective study

Bandana Sharma; Himani Malviya; Anchal Malik; Neha Swayam

doi:10.18203/2320-1770.ijrcog20242807

Authors

Bandana Sharma Department of Obstetrics and Gynecology, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Uttar Pradesh, India
Himani Malviya Department of Obstetrics and Gynecology, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Uttar Pradesh, India
Anchal Malik Department of Obstetrics and Gynecology, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Uttar Pradesh, India
Neha Swayam Department of Obstetrics and Gynecology, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20242807

Keywords:

Antenatal care, Perinatal mortality, Retrospective study, Stillbirths, Tertiary care center

Abstract

Background: Perinatal mortality remains a significant global health issue, reflecting the quality of maternal and neonatal care. In Uttar Pradesh, India, where healthcare challenges are pronounced, understanding the specific factors contributing to perinatal mortality is crucial. This study aims to analyse and evaluate the patterns, causes, and contributing factors of perinatal mortality in a tertiary healthcare center in Kanpur.

Methods: This retrospective observational study was conducted at GSVM Medical College, Kanpur, from April 1, 2023, to March 31, 2024. Data on maternal and fetal characteristics were collected from hospital files and neonatal outcomes from the NICU. Inclusion criteria included stillborn babies born after 28 weeks of gestation and newborns who died within the first 7 days of life. Cases were excluded if they were preterm, of low birth weight, or delivered outside the hospital. Descriptive statistics were used to analyze the data.

Results: Among 6,123 deliveries, 212 perinatal deaths were recorded, yielding a perinatal mortality rate of 3.46%. The mean maternal age was 27.67 years. A majority of perinatal deaths (75.5%) involved women with no antenatal care. The leading causes of death were prematurity (23.5%), asphyxia (15.6%), and respiratory distress syndrome (11.8%). Hypertensive disorders, antepartum haemorrhage, and severe anemia were the most common maternal complications. The study revealed significant risks associated with multiparity, lack of prenatal care, and low birth weight.

Conclusions: Reducing perinatal mortality in Uttar Pradesh requires a comprehensive approach, including improved access to antenatal care, strengthened healthcare infrastructure, and community education. Addressing these factors is essential for enhancing maternal and neonatal health outcomes and reducing perinatal mortality rates.

Metrics

Metrics Loading ...

References

Mukherjee SB, Bandhopadhyay T. Perinatal mortality what has changed. Indian Pediatr. 2016;153(3):242-3.

International Institute for Population Sciences (IIPS) and ICF. National Family Health Survey (NFHS-4), 2015-2016, 2017. Available at: https://dhsprogram.com/pubs/pdf/FR339/FR339.pdf. Accessed 01 June 2024.

World Health Organization. Child Health: Health Topics, 2016. Available at: https://www.who.int/health-topics/child-health. Accessed 01 June 2024.

World Health Organization. World Preeclampsia Day Report, 2017.

World Health Organization. UN Inter-agency Group for Child Mortality Estimation neglected tragedy: the global burden of stillbirths, 2022. Available at: https://www.who.int/publications/m/item/a-neglected-tragedy-the-global-burden-of-stillbirths#:~:text=This%20means%20that%20every%20year,term%20economic%20repercussions%20for%20society. Accessed 01 June 2024.

World Health Organization. Newborns: improving survival and well-being. Available at: https://www.who.int/news-room/fact-sheets/detail/newborns-reducing-mortality. Accessed 01 June 2024.

World Health Organization. Sustainable Development Goals (SDG). Available at: https://www.who.int/health-topics/sustainable-development-goals#tab=tab. Accessed 01 June 2024.

Roy MP. Mitigating the stillbirth challenge in India. The Lancet. 2016;387(10032):1995.

Lawn JE, Blencowe H, Waiswe P. And for the Lancet ending preventable stillbirths series study group with the Lancet stillbirth epidemiology investigator group. Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet. 2016;387(10018):587-603.

Flenady V, Koopmans L, Middleton P, Frøen JF, Smith GC, Gibbons K, et al. Major risk factors for stillbirth in high-income countries: a systematic review and meta-analysis. Lancet. 2011;377(9774):1331-40.

Gardosi J, Madurasinghe V, Williams M, Malik A, Francis A. Maternal and fetal risk factors for stillbirth: population based study. BMJ. 2013;346:f108.

Olagbuji BN, Ezeanochie MC, Igbaruma S, Okoigi SO, Ande AB. Stillbirth in cases of severe acute maternal morbidity. Int J Gynaecol Obstet. 2012;119(1):53-6.

Bayou G, Berhan Y. Perinatal mortality and associated risk factors: a case control study. Ethiop J Health Sci. 2012;22(3):153-62.

McClure EM, Pasha O, Goudar SS, Chomba E, Garces A, Tshefu A, et al. Epidemiology of stillbirth in low-middle income countries: a Global Network Study. Acta Obstet Gynecol Scand. 2011;90(12):1379-85.

Pascal M, Sifaeli K, Godfrey G, Vickfarajaeli D et al Perinatal mortality audit in a rural referral hospital in Tanzania to inform future interventions: A descriptive study PLoS One. 2022;17(3):e0264904.

Aragaw YA. Perinatal mortality and associated factor in Jimma University Specialized Hospital, South West Ethiopia. Gynecol Obstet (Sunnyvale). 2016;6(11):409.

Goba GK, Tsegay H, Gebregergs GB, Mitiku M, Kim KA, Alemayehu M. A facility-based study of factors associated with perinatal mortality in Tigray, northern Ethiopia. Int J Gynaecol Obstet. 2018;141(1):113-9.

Fawole AO, Shah A, Tongo O, Dara K, El-Ladan AM, Umezulike AC, et al. Determinants of perinatal mortality in Nigeria. Int J Gynaecol Obstet. 2011;114(1):37-42.

Feresu SA, Harlow SD, Welch K, Gillespie BW. Incidence of stillbirth and perinatal mortality and their associated factors among women delivering at Harare Maternity Hospital, Zimbabwe: a cross-sectional retrospective analysis. BMC Pregn Childbir. 2005;5:1-2.

Diallo AH, Meda N, Zabsonré E, Sommerfelt H, Cousens S, Tylleskär T, PROMISE-EBF study group adi044@ cih. uib. no. Perinatal mortality in rural Burkina Faso: a prospective community-based cohort study. BMC Pregn Childb. 2010;10:1-9.

Tekelab T, Chojenta C, Smith R, Loxton D. The impact of antenatal care on neonatal mortality in sub-Saharan Africa: A systematic review and meta-analysis. PLoS One. 2019;14(9):e0222566.

Arunda M, Emmelin A, Asamoah BO. Effectiveness of antenatal care services in reducing neonatal mortality in Kenya: analysis of national survey data. Glob Health Action. 2017;10(1).

Tuladhar H, Dhakal N. Impact of antenatal care on maternal and perinatal outcome: a study at Nepal Medical College Teaching Hospital. NJOG. 2011.;6(2):37-43.

Devi TC, Singh HS. Prevalence and associated risk factors of preterm birth in India: a review. J Public Health Dev. 2021;2:209-26.

Reddy KM, Ravula SR, Palakollu S, Betha K. Prevalence of preterm birth and perinatal outcome: A rural tertiary teaching hospital-based study. J Fam Med Prim Care. 2022;11(7):3909-14.

van der Ven AJ, Schaaf JM, van Os MA, de Groot CJ, Haak MC, Pajkrt E, et al. Comparison of perinatal outcome of preterm births starting in primary care versus secondary care in Netherlands: a retrospective analysis of nationwide collected data. Obstet Gynecol Int. 2014;2014(1):423575.

Pusdekar YV, Patel AB, Kurhe KG, Bhargav SR, Thorsten V, Garces A, et al. Rates and risk factors for preterm birth and low birthweight in the global network sites in six low- and low middle-income countries. Reprod Health. 2020;17(Suppl 3):187.

Bhatnagar S, Majumder PP, Salunke DM, Interdisciplinary Group for Advanced Research on Birth Outcomes-DBT India Initiative (GARBH-Ini). A pregnancy cohort to study multidimensional correlates of preterm birth in India: study design, implementation, and baseline characteristics of the participants. Am J Epidemiol. 2019;188(4):621-31.

Leach A, McArdle TF, Banya WA, Krubally O, Greenwood BM, Rands C, et al. Neonatal mortality in a rural area of the Gambia. Ann Trop Paediatr 1999;19(1):33-43.

Ngoc NT, Merialdi M, Abdel-Aleem H, Carroli G, Purwar M, Zavaleta N, et al. Causes of stillbirths and early neonatal deaths: data from 7993 pregnancies in six developing countries. Bull World Health Organ 2006;84(9):699-705.

Kambarami R, Matibe P, Pirie D. Risk factors for neonatal mortality: Harare Central Hospital Neonatal Unit-Zimbabwe. Cent Afr J Med. 1999;45(7):169-73.

Chaman R, Naieni KH, Golestan B, et al. Neonatal mortality risk factors in a rural part of Iran: A nested case-control study. Iran J Publ Heal. 2009;38(1):48-52.

Lawoyin TO, Onadeko MO, Asekun-Olarinmoye EO. Neonatal mortality and perinatal risk factors in rural southwestern Nigeria: A community-based prospective study. West Afr J Med. 2010;29(1):19-23.

Sines E, Syed U, Wall S, Worley H. Postnatal care: A critical opportunity to save mothers and newborns. Policy Perspectives on Newborn Health. 2007;1(7).

Feresu SA, Harlow SD, Welch K, Gillespie BW. Incidence of stillbirth and perinatal mortality and their associated factors among women delivering at Harare Maternity Hospital, Zimbabwe: a cross-sectional retrospective analysis. BMC Pregn Child. 2005;5:1-12.

Wildschut HI, Tutein Nolthenius-Puylaert MC, Wiedijk V, Treffers PE, Hubert J. Fetal and neonatal mortality: a matter of care? Report of a survey in Curaçao, Netherlands Antilles. Br Med J 1987;295(6603):894-97.

Mavalankar DV, Trivedi CR, Gray RH. Levels and risks for perinatal mortality in Ahmedabad, India. Bull World Health Organ. 1991;69(4):435-42.

Singhal S, Nymphaea, Nanda S. Maternal and perinatal outcome in antepartum hemorrhage: a study at a tertiary care referral institute. Intern J Gynecol Obstet. 2007;9(2):1-6.

Adekanle DA, Adeyemi AS, Fadero FF. Ante-partum hemorrhage and pregnancy outcome in LAUTECH teaching hospital, southwestern Nigeria. J Med Med Sci. 2011;2(12):1243-7.

Hinderaker SG, Olsen BE, Bergsjo PB, Gasheka P, Lie RT, Havnen J, et al. Avoidable stillbirths and neonatal deaths in rural Tanzania. BJOG. 2003;110(6):616-23.

Mugisho E, Dramaix M, Porignon D, Musubao E, Hennart P. Analysis of data routinely collected in the maternity ward of Rutshuru in the Democratic Republic of the Congo between 1980 and 1998. II. New-born deaths and low birth weights. Sante. 2002;12(2):252-5.