scholarly journals Identifying risk factors for perinatal death at Tororo District Hospital, Uganda: a case-control study

2019 ◽  
Author(s):  
Martha Tesfalul ◽  
Paul Natureeba ◽  
Nathan Day ◽  
Ochar Thomas ◽  
Stephanie L Gaw
Keyword(s):  
Risk Factors ◽  
Low Birthweight ◽  
Case Control Study ◽  
Perinatal Death ◽  
District Hospital ◽  
Breech Presentation ◽  
Multiple Gestation ◽  
Neonatal Deaths ◽  
Targeted Interventions ◽  
Control Study

Abstract Background Sub-Saharan Africa faces a disproportionate burden of perinatal deaths globally. However, data to inform targeted interventions on an institutional level is lacking, especially in rural, non-academic settings. The objective of this study is to identify risk factors for perinatal death at a resource-limited hospital in Uganda. Methods This is a case-control study at a district hospital in eastern Uganda using birth registry data. Cases were admissions with stillbirths or neonatal deaths within 7 days of birth. Controls were admissions immediately preceding and following each case. We compared demographic and obstetric factors between cases and controls to identify risk factors for perinatal death. Subgroup analysis of twin compared to singleton gestation was also performed. Chi square, Fisher's exact, T, and Wilcoxon-Mann-Whitney rank sum tests were utilized for bivariate analysis, and multiple logistic regression for multivariate analysis. Results From January 2014 to December 2014, there were 185 cases of perinatal death, of which 36% (n=69) were macerated stillbirths, 40% (n=76) were fresh stillbirths, and 25% (n=47) were neonatal deaths. The rate of perinatal death prior to discharge was 35.5 per 1,000 deliveries. Factors associated with increased odds perinatal death included: prematurity (adjusted odds ratio (aOR) 19.7, 95% confidence interval (CI) 7.2-49.2), breech presentation (aOR 7.0, CI 1.4-35.5), multiple gestation (aOR 4.0, CI 1.1 – 13.9), cesarean delivery (aOR 3.8, CI 2.3 – 6.4) and low birthweight (aOR 2.5, CI 1.1-5.3). Fresh stillbirth and neonatal deaths were more associated with nulliparity (p = 0.03), grand multiparity (p = 0.01), low birthweight (p = 0.01) and cesarean delivery (p <0.001) than macerated stillbirths. Subgroup analysis of twin pregnancies revealed that compared to singletons, twins were more likely to have a fresh stillbirth (68.4% vs 36.8%, p = 0.01). Conclusions The rate of perinatal death at a rural district hospital was higher than national rates, and the 67% of cases were fresh stillbirths or neonatal deaths. Significant risk factors for perinatal death were prematurity, breech presentation, and multiple gestation. Targeted interventions to identify these higher risk pregnancies, such as the prenatal identification of twins, may reduce the rate of perinatal death in rural settings.

scholarly journals Identifying risk factors for perinatal death at Tororo District Hospital, Uganda: a case-control study

2019 ◽  
Author(s):  
Martha Tesfalul ◽  
Paul Natureeba ◽  
Nathan Day ◽  
Ochar Thomas ◽  
Stephanie L Gaw
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Case Control Study ◽  
Perinatal Death ◽  
Breech Presentation ◽  
Multiple Gestation ◽  
Neonatal Deaths ◽  
Targeted Interventions ◽  
Control Study

Abstract Background Sub-Saharan Africa faces a disproportionate burden of perinatal deaths globally. However, data to inform targeted interventions on an institutional level is lacking, especially in rural settings. The objective of this study is to identify risk factors for perinatal death at a resource-limited hospital in Uganda. Methods This is a retrospective case-control study at a district hospital in eastern Uganda using birth registry data. Cases were admissions with stillbirths at or beyond 24 weeks or neonatal deaths within 28 days of birth. Controls were admissions that resulted in deliveries immediately preceding and following each case. We compared demographic and obstetric factors between cases and controls to identify risk factors for perinatal death. Subgroup analysis of type of perinatal death was also performed. Chi square, Fisher's exact, t-test, and Wilcoxon-Mann-Whitney rank sum tests were utilized for bivariate analysis, and multiple logistic regression for multivariate analysis. Results From January 2014 to December 2014, there were 185 cases of perinatal death, of which 36% (n=69) were macerated stillbirths, 40% (n=76) were fresh stillbirths, and 25% (n=47) were neonatal deaths. The rate of perinatal death among all deliveries at the institution was 35.5 per 1,000 deliveries. Factors associated with increased odds perinatal death included: prematurity (adjusted odds ratio (aOR) 19.7, 95% confidence interval (CI) 7.2-49.2), breech presentation (aOR 7.0, CI 1.4-35.5), multiple gestation (aOR 4.0, CI 1.1 – 13.9), cesarean delivery (aOR 3.8, CI 2.3 – 6.4) and low birth weight (aOR 2.5, CI 1.1-5.3). Analysis by subtype of perinatal death revealed distinct associations with the aforementioned risk factors, in particular for antepartum hemorrhage, which was only associated with fresh stillbirths (aOR 6.7, CI 1.6-28.8), and low birth weight. Conclusions The rate of perinatal death at our rural hospital site was higher than national targets, and these deaths were associated with prematurity, low birth weight, breech presentation, multiple gestation, and cesarean delivery. This data and the approach can be utilized to acquire it can be leveraged to inform targeted interventions to reduce the rate of stillbirths and neonatal deaths in similar low resource settings.

scholarly journals Identifying risk factors for perinatal death at Tororo District Hospital, Uganda: a case-control study

2020 ◽  
Author(s):  
Martha Tesfalul ◽  
Paul Natureeba ◽  
Nathan Day ◽  
Ochar Thomas ◽  
Stephanie L Gaw
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Case Control Study ◽  
Perinatal Death ◽  
Breech Presentation ◽  
Multiple Gestation ◽  
Neonatal Deaths ◽  
Targeted Interventions ◽  
Control Study

Abstract Background Sub-Saharan Africa faces a disproportionate burden of perinatal deaths globally. However, data to inform targeted interventions on an institutional level is lacking, especially in rural settings. The objective of this study is to identify risk factors for perinatal death at a resource-limited hospital in Uganda. Methods This is a retrospective case-control study at a district hospital in eastern Uganda using birth registry data. Cases were admissions with stillbirths at or beyond 24 weeks or neonatal deaths within 28 days of birth. Controls were admissions that resulted in deliveries immediately preceding and following each case. We compared demographic and obstetric factors between cases and controls to identify risk factors for perinatal death. Subgroup analysis of type of perinatal death was also performed. Chi square, Fisher's exact, t-test, and Wilcoxon-Mann-Whitney rank sum tests were utilized for bivariate analysis, and multiple logistic regression for multivariate analysis. Results From January 2014 to December 2014, there were 185 cases of perinatal death, of which 36% (n=69) were macerated stillbirths, 40% (n=76) were fresh stillbirths, and 25% (n=47) were neonatal deaths. The rate of perinatal death among all deliveries at the institution was 35.5 per 1,000 deliveries. Factors associated with increased odds perinatal death included: prematurity (adjusted odds ratio (aOR) 19.7, 95% confidence interval (CI) 7.2-49.2), breech presentation (aOR 7.0, CI 1.4-35.5), multiple gestation (aOR 4.0, CI 1.1 – 13.9), cesarean delivery (aOR 3.8, CI 2.3 – 6.4) and low birth weight (aOR 2.5, CI 1.1-5.3). Analysis by subtype of perinatal death revealed distinct associations with the aforementioned risk factors, in particular for antepartum hemorrhage, which was only associated with fresh stillbirths (aOR 6.7, CI 1.6-28.8), and low birth weight. Conclusions The rate of perinatal death at our rural hospital site was higher than national targets, and these deaths were associated with prematurity, low birth weight, breech presentation, multiple gestation, and cesarean delivery. This data and the approach utilized to acquire it can be leveraged to inform targeted interventions to reduce the rate of stillbirths and neonatal deaths in similar low resource settings.

scholarly journals Identifying risk factors for perinatal death at Tororo District Hospital, Uganda: a case-control study

2019 ◽  
Author(s):  
Martha Tesfalul ◽  
Paul Natureeba ◽  
Nathan Day ◽  
Ochar Thomas ◽  
Stephanie L Gaw
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Case Control Study ◽  
Perinatal Death ◽  
Breech Presentation ◽  
Multiple Gestation ◽  
Neonatal Deaths ◽  
Targeted Interventions ◽  
Control Study

Abstract Background Sub-Saharan Africa faces a disproportionate burden of perinatal deaths globally. However, data to inform targeted interventions on an institutional level is lacking, especially in rural settings. The objective of this study is to identify risk factors for perinatal death at a resource-limited hospital in Uganda. Methods This is a retrospective case-control study at a district hospital in eastern Uganda using birth registry data. Cases were admissions with stillbirths at or beyond 24 weeks or neonatal deaths within 28 days of birth. Controls were admissions that resulted in deliveries immediately preceding and following each case. We compared demographic and obstetric factors between cases and controls to identify risk factors for perinatal death. Subgroup analysis of type of perinatal death was also performed. Chi square, Fisher's exact, t-test, and Wilcoxon-Mann-Whitney rank sum tests were utilized for bivariate analysis, and multiple logistic regression for multivariate analysis. Results From January 2014 to December 2014, there were 185 cases of perinatal death, of which 36% (n=69) were macerated stillbirths, 40% (n=76) were fresh stillbirths, and 25% (n=47) were neonatal deaths. The rate of perinatal death among all deliveries at the institution was 35.5 per 1,000 deliveries. Factors associated with increased odds perinatal death included: prematurity (adjusted odds ratio (aOR) 19.7, 95% confidence interval (CI) 7.2-49.2), breech presentation (aOR 7.0, CI 1.4-35.5), multiple gestation (aOR 4.0, CI 1.1 – 13.9), cesarean delivery (aOR 3.8, CI 2.3 – 6.4) and low birth weight (aOR 2.5, CI 1.1-5.3). Analysis by subtype of perinatal death revealed distinct associations with the aforementioned risk factors, in particular for antepartum hemorrhage, which was only associated with fresh stillbirths (aOR 6.7, CI 1.6-28.8), and low birth weight. Conclusions The rate of perinatal death at our rural hospital site was higher than national targets, and these deaths were associated with prematurity, low birth weight, breech presentation, multiple gestation, and cesarean delivery. This data and the approach utilized to acquire it can be leveraged to inform targeted interventions to reduce the rate of stillbirths and neonatal deaths in similar low resource settings.

scholarly journals Identifying risk factors for perinatal death at Tororo District Hospital, Uganda: a case-control study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Martha A. Tesfalul ◽  
Paul Natureeba ◽  
Nathan Day ◽  
Ochar Thomas ◽  
Stephanie L. Gaw
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Perinatal Death ◽  
District Hospital ◽  
Case Control ◽  
Tororo District ◽  
Control Study

scholarly journals Risk factors for perinatal death in two different levels of care: a case–control study

2014 ◽  
Vol 11 (1) ◽  
Author(s):  
Paula Maria Silveira Soares Moura ◽  
Izildinha Maestá ◽  
Lígia Maria Souza Suppo Rugolo ◽  
Luís Felipe Ramos Berbel Angulski ◽  
Antônio Prates Caldeira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Perinatal Death ◽  
Case Control ◽  
Levels Of Care ◽  
Different Levels ◽  
Control Study

scholarly journals A case-control study of risk factors for fetal and early neonatal deaths in a tertiary hospital in Kenya

2014 ◽  
Vol 14 (1) ◽  
Author(s):  
Faith Yego ◽  
Catherine D’Este ◽  
Julie Byles ◽  
Paul Nyongesa ◽  
Jennifer Stewart Williams
Keyword(s):  
Risk Factors ◽  
Case Control Study ◽  
Tertiary Hospital ◽  
Case Control ◽  
Neonatal Deaths ◽  
Early Neonatal Deaths ◽  
Control Study

scholarly journals The magnitude of perinatal mortality rate and associated risk factors among deliveries at Dilla University Referral Hospital, Southern Ethiopia: A case-control study

2022 ◽  
Vol 9 (1) ◽  
Author(s):  
Kefale Lelamo Legu ◽  
Alemu Tamiso Debiso ◽  
Kaleb Mayisso Rodamo
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Perinatal Mortality ◽  
Case Control Study ◽  
Case Control ◽  
Neonatal Deaths ◽  
Perinatal Mortality Rate ◽  
Associated Risk Factors ◽  
Early Neonatal Deaths ◽  
Control Study

The perinatal mortality rate is the sum of stillbirths and early neonatal deaths divided by the number of pregnancies of seven or more months’ duration. In Ethiopia, the death rate was 33 deaths/1000 total births in 2016. We aimed to identify the perinatal mortality rate and associated risk factors among deliveries in Dilla University Referral Hospital; January, 2016 - December, 2018. A hospital based retrospective case-control study was conducted using subgroup binary logistic regression analysis including 138 cases and 296 control group. The proportion of hospital perinatal deaths was 30% with 90% of the deaths were occurred as a result of stillbirths and antepartum hemorrhage. Adjusted odds ratios revealed that history of still birth, very low birth weight, short interval and nonuse of partograph found to be independent predictors of both stillbirths and early neonatal deaths besides to pregnancy induced hypertension and antepartum hemorrhage. The risk of perinatal mortality may be increased by not treating chronic illnesses, obstetrics complications and risk factors causing low birth weight as well as short birth intervals and not using partograph during labour.

Risk factors for esophageal adenocarcinoma: A case-control study

2001 ◽  
Vol 120 (5) ◽  
pp. A442-A442
Author(s):  
B AVIDAN ◽  
A SONNENBERG ◽  
T SCHNELL ◽  
G CHEJFEC ◽  
A METZ ◽  
...  
Keyword(s):  
Risk Factors ◽  
Esophageal Adenocarcinoma ◽  
Case Control Study ◽  
Case Control ◽  
Control Study
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