Abstract
Perinatal mortality rate has been regarded as an indicator of the quality of prenatal, obstetric and neonatal care in an area, which also reflects the maternal health and socioeconomic environment. The objective of the current study was to identify causes and risk factors for perinatal deaths among the tribal population in Jawadhi Hills, Tamil Nadu, southern India. A community-based case control study design was used, where a case was a perinatal death and controls were from a sampling frame of all children who were born alive in the same area ±7 days from the day of birth of the case. The WHO Standard International Verbal Autopsy form was used to arrive at the cause of death. Univariate and multivariate analyses for factors associated with perinatal deaths were done. A total of 40 cases, including 22 early neonatal deaths and 18 stillbirths, and 110 controls were included in the study. Among the perinatal deaths, 40% were born prematurely. Sepsis (17.5%) and birth asphyxias (12.5%) were the major causes of deaths. In the final logistic regression model, parity ≥4 (odds ratio [OR] 5.75 [95% confidence interval (CI) 1.88-17.54]), preterm births (OR 5.62 [95% CI 2.12-16.68]) and time to reach the nearest health facility more than two hours (OR 2.51 [95% CI 1.086.73]) were significantly associated with the perinatal deaths. Prematurity, poor accessibility and a high parity were significantly associated with perinatal deaths in the tribal population of Jawadhi Hills.
Highlights
Perinatal mortality rate has been regarded as an indicator of the quality of prenatal, obstetric and neonatal care in an area, which reflects the maternal health and socioeconomic environment
During the study period from 1 February to 30 July 2012, 288 births and 43 perinatal deaths were reported with a perinatal mortality rate of 149.3/1000 births
In 44.5% of controls and 15% of cases, a new blade was used to cut the umbilical cord. Those who had to travel more than two hours to reach a health facility had odds ratio (OR) 2.67 for perinatal death as compared to those living in places from where the healthcare facility could be reached within two hours
Summary
Perinatal mortality rate has been regarded as an indicator of the quality of prenatal, obstetric and neonatal care in an area, which reflects the maternal health and socioeconomic environment. The objective of the current study was to identify causes and risk factors for perinatal deaths among the tribal population in Jawadhi Hills, Tamil Nadu, southern India. Conclusions: Prematurity, poor accessibility and a high parity were significantly associated with perinatal deaths in the tribal population of Jawadhi Hills. Perinatal mortality reflects the quality of health care during pregnancy and early neonatal period. Most of these deaths are potentially preventable with good quality health services, including antenatal and intranatal care[2]. In India, perinatal mortality rate (PMR) stood at 32 per 1000 births in 2010. It is high in rural areas (35/1000) compared to urban areas (23/1000). The PMR significantly varied across the states, Kerala (13/1000) being the lowest and Madhya Pradesh and Chhattisgarh (45/1000) being the highest[3]
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