A case-control study of risk factors for fetal and early neonatal deaths in a tertiary hospital in Kenya
2014 (English)In: BMC Pregnancy and Childbirth, ISSN 1471-2393, Vol. 14, 389- p.Article in journal (Refereed) Published
BackgroundIt is important to understand the risk factors for fetal and neonatal mortality which is a major contributor to high under five deaths globally. Fetal and neonatal mortality is a sensitive indicator of maternal health in society. This study aimed to examine the risk factors for fetal and early neonatal mortality at the Moi Teaching and Referral Hospital in Kenya.MethodsThis was a case-control study. Cases were fetal and early neonatal deaths (n¿=¿200). The controls were infants born alive immediately preceding and following the cases (n¿=¿400). Bivariate comparisons and multiple logistic regression analyses were undertaken.ResultsThe odds of having 0-1 antenatal visits relative to 2-3 visits were higher for cases than controls (AOR=4.5; 95% CI: 1.2-16.7; p=0.03). There were lower odds among cases of having a doctor rather than a midwife as a birth attendant (OR¿=¿0.2; 95% CI: 0.1-0.6; p¿<¿0.01). The odds of mothers having Premature Rupture of Membranes (OR¿=¿4.1; 95% CI: 1.4-12.1; p¿=¿0.01), haemorrhage (OR¿=¿4.8; 95% CI: 1.1-21.9; p¿=¿0.04) and dystocia (OR¿=¿3.6; 95% CI: 1.2-10.9; p¿=¿0.02) were higher for the cases compared with the controls. The odds of gestational age less than 37 weeks (OR¿=¿7.0; 95% CI 2.4-20.4) and above 42 weeks (OR¿=¿16.2; 95% CI 2.8-92.3) compared to 37-42 weeks, were higher for cases relative to controls (p¿<¿0.01). Cases had higher odds of being born with congenital malformations (OR¿=¿6.3; 95% CI: 1.2-31.6; p¿=¿0.04) and with Apgar scores of below six at five minutes (OR¿=¿26.4; 95% CI: 6.1-113.8; p¿<¿0.001).ConclusionInterventions that focus on educating mothers on antenatal attendance, screening, monitoring and management of maternal conditions during the antenatal period should be strengthened. Doctor attendance at each birth and for emergency admissions is important to ensure early neonatal survival and avert potential risk factors for mortality.
Place, publisher, year, edition, pages
2014. Vol. 14, 389- p.
Public Health, Global Health, Social Medicine and Epidemiology
IdentifiersURN: urn:nbn:se:umu:diva-98491DOI: 10.1186/s12884-014-0389-8ISI: 000348464200001PubMedID: 25432735OAI: oai:DiVA.org:umu-98491DiVA: diva2:782825