Abstract
Georgia has one of the highest perinatal mortality rates (i.e., stillbirths and early neonatal deaths combined) in Europe. The Georgian Birth Registry was started in 2016 to provide data for preventive measures of maternal and child health. In this study, we aim to determine the incidence of perinatal mortality, assess the distribution of stillbirths and early neonatal deaths, and to determine the major causes of perinatal mortality in Georgia. Data sources were the Georgian Birth Registry and the vital registration system for the year 2017. Causes of early neonatal deaths were assigned into five categories, using the Wigglesworth classification with the Neonatal and Intrauterine deaths Classification according to Etiology modification. The study used descriptive statistics only, specifically counts, means, proportions, and rates, using the statistical software STATA version 15.0 (StataCorp, College Station, TX, USA). In 2017, 489 stillbirths and 238 early neonatal deaths were recorded, resulting in a perinatal mortality rate of 13.6 per 1000 births. About 80% of stillbirths had an unknown cause of death. The majority of stillbirths occurred before the start of labor (85%), and almost one-third were delivered by caesarean section (28%). Prematurity (58%) and congenital malformations (23%) were the main causes of early neonatal deaths, and 70% of early neonatal deaths occurred after the first day of life. The perinatal mortality rate in Georgia remained high in 2017. The major causes of early neonatal deaths were comparable to those of many high-income countries. Contrary to global data, most early neonatal deaths occurred after the first day of life.
Highlights
Significant improvement in child survival has been achieved worldwide over the past 25 years
This study aims to determine the incidence of perinatal mortality (PM), assess the distribution of stillbirths and early neonatal death (END), and determine the major causes of PM in Georgia in 2017
Sixty-six additional ENDs were identified in the vital registration system (VRS) as newborns who die at home or after transfer to another hospital were not be registered as PM in the Georgian Birth Registry (GBR)
Summary
Significant improvement in child survival has been achieved worldwide over the past 25 years. The mortality rate for children under the age of 5 years decreased from 91 deaths per 1000 livebirths in 1990 to 43 per 1000 in 2015 [1,2]. Death during the first month of life (the neonatal period) accounts for around 45% of mortality among children under the age of 5 years. Of those deaths, the majority (≈75%) occurs during the first 7 days of life (the early neonatal period) [3,4,5], and >50% occur during the first 24 hours [3,6,7]. Since 2000, stillbirth rates have decreased by 25% globally [8], but there are still large disparities between countries [9]
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