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Factors associated with and causes of perinatal mortality in northeastern Tanzania.
MedLine Citation:
PMID:  22676243     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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) were protective for perinatal mortality. Fourty-three percent of the deaths were due to complications related to labor with 30% attributed to intrapartum asphyxia and 13% to neonatal infection. 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.
Authors:
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
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-7
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  -     ISSN:  1600-0412     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
Centre for Medical Parasitology, Institute of International Health, Immunology, and Microbiology, University of Copenhagen and Department of Infectious Diseases, Copenhagen University Hospital, Copenhagen, Denmark National Institute for Medical Research, Tanga Medical Research Center, Tanga, Tanzania Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands Department of Clinical Pathology, Odense University Hospital, Odense, Denmark Department of Immunology, Wenner-Gren Institute, Stockholm University, Stockholm, Sweden Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.
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