Factors associated with perinatal deaths in women delivering in a health facility in malawi
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Factors associated with perinatal deaths in women delivering in a health facility in Malawi. Lily C. Kumbani, Johanne Sundby and Jon Øyvind Odland. Outline. Introduction Study Purpose Methodology Results Implications. Introduction.

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Factors associated with perinatal deaths in women delivering in a health facility in malawi

Factors associated with perinatal deaths in women delivering in a health facility in Malawi

Lily C. Kumbani, Johanne Sundby and Jon Øyvind Odland


Outline
Outline in a health facility in Malawi

  • Introduction

  • Study Purpose

  • Methodology

  • Results

  • Implications


Introduction
Introduction in a health facility in Malawi

  • Newborn deaths account for 40% of under- five mortality (MDG- 4).

  • Reducing early neonatal mortality is necessary to achieve MDG- 4.


Introduction ctd
Introduction ctd… in a health facility in Malawi

  • Two-thirds of child deaths occur in the first month of life. Of these, more than two-thirds die in their first week. Among those in the first week, two-thirds die in the first 24 hours of life.

  • Unless neonatal mortality is greatly reduced it is not possible to achieve millennium development goal 4.


Introduction ctd1
Introduction ctd… in a health facility in Malawi

  • In Malawi, an increase in perinatal mortality estimated at 40/1000 (MDHS 2010)

  • Few studies done.

  • These data are essential to effectively plan how to reduce perinatal mortality.


Objectives
Objectives in a health facility in Malawi

  • To establish an estimate of perinatal mortality at Chiradzulu District Hospital.

  • To identify associated risk factors, and to determine causes of perinatal deaths.


Methodology
Methodology in a health facility in Malawi

  • Design: A cross sectional prospective review of records.

  • Setting: Chiradzulu district hospital, labor ward and postnatal ward.

  • Inclusion criteria: Records of mothers who received antenatal care at any health facility but delivered at the district hospital from 28 weeks to term.


Methodology ctd
Methodology ctd… in a health facility in Malawi

Data collection:

  • A data record form: was used to collect maternal and neonatal information

    Data analysis

  • Stata version 11.0 was used

  • Univariate analysis was computed to determine the association between outcome (perinatal death) and independent variables.


Methodology ctd1
Methodology ctd… in a health facility in Malawi

Ethical consideration:

  • Study approval - Norway Regional Committee for Medical Research Ethics & College of Medicine Research and Ethics Committee, Malawi.

  • Written permission from the District Health Officer - Chiradzulu District Hospital


Results
Results in a health facility in Malawi


Results mothers characteristics
Results- Mothers’ characteristics in a health facility in Malawi


Results mothers characteristics ctd
Results- Mothers’ in a health facility in Malawicharacteristics ctd…


Results frequency of perinatal deaths
Results - in a health facility in MalawiFrequency of perinatal deaths


Results frequency of perinatal deaths ctd
Results - in a health facility in MalawiFrequency of perinatal deaths ctd…


Distribution of perinatal deaths
Distribution of perinatal deaths in a health facility in Malawi


Causes of early neonatal deaths
Causes of early neonatal deaths in a health facility in Malawi


Results univariate analysis pregnancy
Results- univariate analysis (Pregnancy) in a health facility in Malawi

Maternal age, parity, HIV, syphilis, preeclampsia, anemia, malaria and APH had no effect on perinatal deaths

(p >0.05).


Results univariate analysis labor delivery
Results- univariate analysis (Labor/Delivery) in a health facility in Malawi



Results univariate analysis labor delivery ctd1
Results- univariate analysis (Labor/Delivery) ctd… in a health facility in Malawi

Anemia, obstetric complications (preeclampsia, eclampsia, rupture of membranes > 24 hours, fetal distress, CPD, obstructed labor), and skilled attendant were not associated with perinatal deaths (p >0.05).


Results univariate analysis postpartum
Results- univariate analysis (Postpartum) in a health facility in Malawi


Results univariate analysis postpartum ctd
Results- univariate analysis (Postpartum) ctd.. in a health facility in Malawi

Meconium aspiration and hypothermia were not associated with perinatal deaths (p >0.05).


Implications
Implications in a health facility in Malawi

  • Reinforce and improve health workers’ abilities to properly monitor women in labor at all levels of care for early identification and management of complications.

  • Encourage women to start antenatal care early for them to adhere to the four recommended antenatal visits.

  • Improve health workers ability in basic resuscitation, as well as care of low birth weight babies.


Implications ctd
Implications ctd… in a health facility in Malawi

  • Referral of women with very preterm labor (28 to 32 weeks) to deliver in a facility with neonatal intensive care.

  • Pregnant women and communities should have sufficient information on obstetric complications to seek health care in time.


Thank you for your attention in a health facility in Malawi


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