Determinants OfPerinational Mortality:Amatched Case Control study,in Jimma University Specialized hospital,Ethiopia

Abstract

BACKGROUND: Although being newborn is not a disease, large numbers of children die soon after birth or born died (stillbirth). In many countries including Ethiopia major changes are taking place in the area of maternal and child health to achieve the goals set out on international declarations and country commitments. Early neonatal death which accounts around one third of the total child death is not decreasing as needed and even increasing in some countries which is also true for perinatal mortality. OBJECTIVE: The main objective of the study was to assess trend and identify factor associated with perinatal mortality among perinatal age groups from January 1st, 2011to December 30th, 2014 METHOD: Facility based matched case control study was employed using four year data from JUSH perinatal deaths and early neonatal records. The cases were stillbirths and early neonatal deaths and controls were live births and early neonates discharged or stayed alive up to their seven days. A total of 1,593 (531 cases and 1062 controls) subjects constituted the sample size for this study. The number of stillbirth cases were 429 and 858 were selected as a control for these group and early neonatal death was recorded in 102 of the cases for whom 204 controls were selected. In order to identify the independent predictors of perinatal mortality, a number of covariates were entered in a conditional multiple logistic regression model based on set criteria. Sub group analysis was also conducted for early neonatal deaths and stillbirths to see their specific predictors. stata version 12 was used to conduct the analysis. RESULT: From total birth occur within the study period the overall rate of perinatal mortality were 87.4 with C-I (82.7, 92.1). 467 (87.9) of cases and 348 (32.8) of controls had at least one obstetrics complication. The odds of having PND among mothers with at least one obstetrics complications was 8.4 times as much as those who didn’t have obstetric complications (OR; 8.4 ; 95% CI: 4.4 – 16.0) ; while in the sub group analysis the odds of stillbirth and ENND was 10.4, and 4.4 times as much for those with at least one obstetric complications compared to those without complication. CONCLUSION AND RECOMMENDATION: Birth weight, having at least one complication, uterine rapture, obstructed labor were the independent predictors of PND. Generally to decrease PND activities should have to be done on assessing the causes and reducing identified maternal complications.