Impact of prenatal care on perinatal mortality.

This study aimed to estimate the perinatal mortality rate (PMR) in Ho Chi Minh City, Vietnam, and to assess the association between perinatal death (PD) and prenatal care (PC). During January 1st to December 31st, 1992, among 4,809 births ascertained from 22 communes randomly selected in two areas, urban and rural, of Ho Chi Minh City, 48 still births and 66 early neonatal deaths were recorded, resulting in a weighted PMR of 25 (95% confidence interval: 20-29) per thousand. Major causes of PD were prematurity 33%, congenital malformation 15%, perinatal asphyxia 12%, perinatal infection 11%, birth injury 4%, others 8% and unknown 16%. From the whole sample, a nested case-control study was conducted on 103 cases (all the mothers whose infants died) and 309 controls (selected among the mothers of surviving infants) to assess the relationship between PD and prenatal care (PC). During unconditional logistic regression, starting prenatal care (PC) within the 1st trimester was associated with a lower risk of PD, giving an odds ratio of 0.11 (95% CI: 0.02-0.61), whereas having 4 to 8 visits gave an odds ration of 0.15 (95% CI: 0.03-0.67). It is concluded that early onset of prenatal care and having four to eight visits provide significant protection against perinatal mortality.