A retrospective analysis of the risk factors leading to perinatal mortality at a tertiary care hospital of Sikkim, India
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20182338Keywords:
Early neonatal deaths, Maternal risk factors, Perinatal mortality, StillbirthsAbstract
Background: This study helps to assess the burden of perinatal mortality at a tertiary referral hospital in Sikkim known for its hilly terrain which makes health services difficult to access. The aims and objectives were to determine the various causes and risk factors leading to perinatal mortality in order to formulate preventive strategies
Methods: All perinatal deaths over a year between August 2016-2017 were included and analysed in our study.
Results: A stillbirth rate of 14 per 1000 total births and early neonatal death rate of 8 per 1000 live births was found in 1855 total births. Complications related to pregnancy like pre-eclampsia (16%), eclampsia (8%), ante-partum haemorrhage (15%) and medical disorders (13%) were major contributors to stillbirths while pre-maturity (53.3%), sepsis (20%), birth asphyxia due to meconium aspiration (13.3%) were notable factors leading to early neonatal deaths. In majority of the cases, factors like poor literacy, low socio-economic status, increased basal metabolic index and inadequate ante-natal care caused increased perinatal losses.
Conclusions: Perinatal grief continues to surround women who have suffered perinatal deaths and serious efforts should be made to bring down the mortality rates by improving health , nutrition of all expecting mothers and increase their awareness to seek ante-natal health services in order to avoid any catastrophe in terms of maternal and fetal loss.
References
PMR Reflects Health Status: WHO library Cataloguing in Publication. Data neonatal & perinatal mortality: Country, regional and global estimates. 2006.
Mukherjee SB, Bandhopadhyay T. Perinatal mortality- what has changed: Indian Pediatr. 2016;153:242-3.
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;387:587-603.
Rahman H, Dutta S, Choudhury P, Kar S, Nandi P. (2014). Determinants of stillbirths in a teaching hospital of Sikkim Province of India. J Womens Health Issues Care. 2014;3:5.
Sankar MJ, Neogi SB, Sharma J, Chauhan M, Srivastava R, Prabhakar PK, et al. State of newborn health in India. J Perinatol. 2016;36(Suppl 3):S3-8.
Paul VK, Sachdev HS, Mavalankar D, Ramachandran P, Sankar MJ, Bhandari N, et al . Reproductive health and child health and malnutrition in India: meeting the challenge. Lancet 2011;377:332-349.
Conde- Agudelo A, Belizan JM, Lammers C. Maternal –perinatal morbidity and mortality associated with adolescent pregnancy in Latin America: cross-sectional study. Am J Obstet Gynecol. 2005;192(2):342-9.
Korde- Nayak, VN and Gaikwad, PR. Causes of stillbirth. J Obstet Gynecol India. 2008;58:314-8.
Blencowe H, Cousens S, Jassir FB, Say L, Chou D, Mathers C, et al. National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis. Lancet Glob Health. 2016;4:e98-108.
