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) protected against perinatal mortality. The cause of death in 43% of cases was attributed to complications related to labor and specifically to intrapartum asphyxia (30%) and neonatal infection (13%). 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.
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) protected against perinatal mortality. The cause of death in 43% of cases was attributed to complications related to labor and specifically to intrapartum asphyxia (30%) and neonatal infection (13%). 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: Steve M Taylor; Mwayiwawo Madanitsa; Kyaw-Lay Thwai; Carole Khairallah; Linda Kalilani-Phiri; Anna M van Eijk; Victor Mwapasa; Feiko O Ter Kuile; Steven R Meshnick Journal: J Infect Dis Date: 2017-08-01 Impact factor: 5.226
Authors: Naoko Kozuki; Joanne Katz; Anne C C Lee; Joshua P Vogel; Mariangela F Silveira; Ayesha Sania; Gretchen A Stevens; Simon Cousens; Laura E Caulfield; Parul Christian; Lieven Huybregts; Dominique Roberfroid; Christentze Schmiegelow; Linda S Adair; Fernando C Barros; Melanie Cowan; Wafaie Fawzi; Patrick Kolsteren; Mario Merialdi; Aroonsri Mongkolchati; Naomi Saville; Cesar G Victora; Zulfiqar A Bhutta; Hannah Blencowe; Majid Ezzati; Joy E Lawn; Robert E Black Journal: J Nutr Date: 2015-09-30 Impact factor: 4.798
Authors: Joanne Katz; Anne Cc Lee; Naoko Kozuki; Joy E Lawn; Simon Cousens; Hannah Blencowe; Majid Ezzati; Zulfiqar A Bhutta; Tanya Marchant; Barbara A Willey; Linda Adair; Fernando Barros; Abdullah H Baqui; Parul Christian; Wafaie Fawzi; Rogelio Gonzalez; Jean Humphrey; Lieven Huybregts; Patrick Kolsteren; Aroonsri Mongkolchati; Luke C Mullany; Richard Ndyomugyenyi; Jyh Kae Nien; David Osrin; Dominique Roberfroid; Ayesha Sania; Christentze Schmiegelow; Mariangela F Silveira; James Tielsch; Anjana Vaidya; Sithembiso C Velaphi; Cesar G Victora; Deborah Watson-Jones; Robert E Black Journal: Lancet Date: 2013-06-06 Impact factor: 79.321
Authors: Stanley Mwita; Eveline Konje; Benjamin Kamala; Angelina Izina; Semvua Kilonzo; Andrew Kigombola; Karol J Marwa; Mary Jande; Deborah Dewey Journal: PLoS One Date: 2021-07-22 Impact factor: 3.240
Authors: Bernard Mbwele; Nicole L Ide; Elizabeth Reddy; Sarah A P Ward; Joshua A Melnick; Flavian A Masokoto; Rachael Manongi Journal: BMC Pediatr Date: 2013-05-03 Impact factor: 2.125