| Autor: |
Arach AAO; Department of Nursing and Midwifery, Faculty of Health Sciences, Lira University , Lira, Uganda.; Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences , Kampala, Uganda., Tumwine JK; Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences , Kampala, Uganda., Nakasujja N; Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences , Kampala, Uganda., Ndeezi G; Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences , Kampala, Uganda., Kiguli J; Department of Community Health and Behavioural Sciences, School of Public Health, Makerere University, College of Health Sciences , Kampala, Uganda., Mukunya D; Department of Research, Sanyu Africa Research Institute , Mbale, Uganda.; Department of Public Health, Busitema University Faculty of Health Sciences , Mbale, Uganda., Odongkara B; Department of Paediatrics and Child Health, Gulu University , Gulu, Uganda., Achora V; Department of Obstetrics and Gynaecology, Gulu University , Gulu, Uganda., Tongun JB; Department of Paediatrics and Child Health, University of Juba , Juba, South Sudan., Musaba MW; Department of Obstetrics and Gynaecology, Busitema University Faculty of Health Sciences , Mbale, Uganda., Napyo A; Department of Public Health, Busitema University Faculty of Health Sciences , Mbale, Uganda., Tylleskar T; Centre for International Health, University of Bergen , Bergen, Norway., Nankabirwa V; Department of Epidemiology and Biostatistics, School of Public Health, Makerere University College of Health Sciences , Kampala, Uganda.; Centre for Intervention Science and Maternal Child Health (CISMAC), Centre for International Health, University of Bergen , Bergen, Norway. |
| Abstrakt: |
Background : Perinatal mortality in Uganda remains high at 38 deaths/1,000 births, an estimate greater than the every newborn action plan (ENAP) target of ≤24/1,000 births by 2030. To improve perinatal survival, there is a need to understand the persisting risk factors for death. Objective : We determined the incidence, risk factors, and causes of perinatal death in Lira district, Northern Uganda. Methods : This was a community-based prospective cohort study among pregnant women in Lira district, Northern Uganda. Female community volunteers identified pregnant women in each household who were recruited at ≥28 weeks of gestation and followed until 50 days postpartum. Information on perinatal survival was gathered from participants within 24 hours after childbirth and at 7 days postpartum. The cause of death was ascertained using verbal autopsies. We used generalized estimating equations of the Poisson family to determine the risk factors for perinatal death. Results : Of the 1,877 women enrolled, the majority were ≤30 years old (79.8%), married or cohabiting (91.3%), and had attained only a primary education (77.7%). There were 81 perinatal deaths among them, giving a perinatal mortality rate of 43/1,000 births [95% confidence interval (95% CI: 35, 53)], of these 37 were stillbirths (20 deaths/1,000 total births) and 44 were early neonatal deaths (23 deaths/1,000 live births). Birth asphyxia, respiratory failure, infections and intra-partum events were the major probable contributors to perinatal death. The risk factors for perinatal death were nulliparity at enrolment (adjusted IRR 2.7, [95% CI: 1.3, 5.6]) and maternal age >30 years (adjusted IRR 2.5, [95% CI: 1.1, 5.8]). Conclusion : The incidence of perinatal death in this region was higher than had previously been reported in Uganda. Risk factors for perinatal mortality were nulliparity and maternal age >30 years. Pregnant women in this region need improved access to care during pregnancy and childbirth. |
