Abstract
BackgroundThere is a scarcity of reliable data on perinatal mortality (PNM) in Sub-Saharan Africa. The PROMISE-EBF trial, during which we promoted exclusive breastfeeding, gave us the opportunity to describe the epidemiology of PNM in Banfora Health District, South-West in Burkina Faso.Study objectivesTo measure the perinatal mortality rate (PNMR) in the PROMISE-EBF cohort in Banfora Health District and to identify potential risk factors for perinatal death.MethodsWe used data collected prospectively during the PROMISE-EBF-trial to estimate the stillbirth rate (SBR) and early neonatal mortality rate (ENMR). We used binomial regression with generalized estimating equations to identify potential risk factors for perinatal death.Results895 pregnant women were enrolled for data collection in the EBF trial and followed-up to 7 days after birth. The PNMR, the SBR and the ENMR, were 79 per 1000 (95% CI: 59-99), 54 per 1000 (95% CI: 38-69) and 27 per 1000 (95% CI: 9-44), respectively. In a multivariable analysis, nulliparous women (RR = 2.90, 95% CI: 1.6-5.0), primiparae mothers (RR = 2.20, 95% CI: 1.2-3.9), twins (RR = 4.0, 95% CI: 2.3-6.9) and giving birth during the dry season (RR = 2.1 95% CI: 1.3-3.3) were factors associated with increased risk of perinatal death. There was no evidence that risk of perinatal death differed between deliveries at home and at a health centreConclusionOur study observed the highest PNMR ever reported in Burkina. There is an urgent need for sustainable interventions to improve maternal and newborn health in the country.
Highlights
There is a scarcity of reliable data on perinatal mortality (PNM) in Sub-Saharan Africa
Our study observed the highest perinatal mortality rate (PNMR) ever reported in Burkina
Because the number of early neonatal deaths (END) was small and there is the potential for misclassification between stillbirths and ENDs, we present only an analysis of risk factors for perinatal death including all births (n = 915)
Summary
There is a scarcity of reliable data on perinatal mortality (PNM) in Sub-Saharan Africa. There is a paucity of reliable data on perinatal mortality in sub-Saharan Africa. This renders the problem invisible to donors and policymakers [3]. The need for better estimates of perinatal mortality in low-income countries, especially in Sub-Saharan Africa, has been stressed by several authors [2,4]. Such estimates are critical for the design and implementation of effective health programmes
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