Determinants of Perinatal Mortality Among Deliveries Attended in Public Hospitals in Hadiya Zone, South Ethiopia

Abstract

Tessema Yoseph, Aklilu Abera, Teshome Bekele, Endalew Lealem and Genet Mishamo

Background: Perinatal mortality is the sum of stillbirth and early neonatal death. Perinatal mortality accounts for three- quarters of the deaths during the neonatal period. Ethiopia is one of the sub-Saharan countries with high perinatal mortality, which accounts for 4% of the world's perinatal mortality.

Objective: To assess the determinants of perinatal mortality among the public hospital deliveries in Hadiya Zone, South Ethiopia.

Methods: An unmatched case-control study was conducted in public hospitals in Hadiya Zone, south Ethiopia, from January 1 to March 30, 2023. cases were stillbirths or early neonatal deaths. Controls were those newborns that were alive until their 7th day of life. Five hundred eighty-two study subjects (194 cases and 388 controls) from delivery registration and the neonatology logbook were recruited for this study. Data were collected using KoboCollect software version 1.29.3 and exported to SPSS version 25 for analysis. Candidate variables with a p-value of less than 0.25 were selected for multivariable analysis by using bivariate analysis. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) was calculated, and variables with a P-value of <0.05 were identified as potential determinants of perinatal mortality.

Result: A total of 582 (194 cases and 388 controls) were reviewed. This study identified that maternal age 21-35 years [AOR=0.38; 95% CI (0.17, 0.84)], rural residence [AOR=2.88: 95% CI (1.29, 6.46)], birth interval less than two years [AOR=5.34: 95% CI (2.59, 10.99)], history of perinatal mortality [AOR=3.2: 95% CI (1.38, 7.43)], less than eight hour duration of labour [AOR=0.19: 95% CI (0.09, 0.40)], obstetric complication [AOR=7.92: 95% CI (3.81, 16.46)], low birth weight [AOR=7.75: 95% CI (3.27, 18.39)], and use of partograph [AOR=0.14: 95% CI (0.07, 0.30)] as factors that determine perinatal mortality.

Conclusion: maternal age, residence, birth interval, history of perinatal mortality, duration of labour, obstetric complication, birth weight, and not the use of a partograph were independent determinants of perinatal mortality. Furthermore, the use of a partograph is recommended for early detection of obstetric complications so that action can be taken during labour follow-up.

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