Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study
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Date
2015
Journal Title
Journal ISSN
Volume Title
Publisher
Conflict and health
Abstract
Perinatal mortality in Uganda remains high at 38 deaths/1,000 births, an
estimate greater than the every newborn action plan (ENAP) target of ≤24/1,000 births by
2030. To improve perinatal survival, there is a need to understand the persisting risk factors
for death.
Objective: We determined the incidence, risk factors, and causes of perinatal death in Lira
district, Northern Uganda.
Methods: This was a community-based prospective cohort study among pregnant women in
Lira district, Northern Uganda. Female community volunteers identified pregnant women in
each household who were recruited at ≥28 weeks of gestation and followed until 50 days
postpartum. Information on perinatal survival was gathered from participants within 24 hours
after childbirth and at 7 days postpartum. The cause of death was ascertained using verbal
autopsies. We used generalized estimating equations of the Poisson family to determine the
risk factors for perinatal death.
Results: Of the 1,877 women enrolled, the majority were ≤30 years old (79.8%), married or
cohabiting (91.3%), and had attained only a primary education (77.7%). There were 81 perinatal
deaths among them, giving a perinatal mortality rate of 43/1,000 births [95% confidence
interval (95% CI: 35, 53)], of these 37 were stillbirths (20 deaths/1,000 total births) and 44 were
early neonatal deaths (23 deaths/1,000 live births). Birth asphyxia, respiratory failure, infections
and intra-partum events were the major probable contributors to perinatal death. The
risk factors for perinatal death were nulliparity at enrolment (adjusted IRR 2.7, [95% CI: 1.3,
5.6]) and maternal age >30 years (adjusted IRR 2.5, [95% CI: 1.1, 5.8]).
Conclusion: The incidence of perinatal death in this region was higher than had previously
been reported in Uganda. Risk factors for perinatal mortality were nulliparity and maternal
age >30 years. Pregnant women in this region need improved access to care during pregnancy
and childbirth.
Description
Keywords
Perinatal death, Perinatal mortality, Early neonatal deaths, Risk factors
Citation
Anna Agnes Ojok Arach, James K. Tumwine, Noeline Nakasujja, Grace Ndeezi, Juliet Kiguli, David Mukunya, Beatrice Odongkara, Vincentina Achora, Justin B. Tongun, Milton W. Musaba, Agnes Napyo, Thorkild Tylleskar & Victoria Nankabirwa (2021) Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study, Global Health Action, 14:1, 1859823, DOI: 10.1080/16549716.2020.1859823