Browsing by Author "Ndyetabura, E. F. M"

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    Factors associated with perinatal mortality in a rural district in Central Western Tanzania
    (University of Dar es Salaam, 1990) Ndyetabura, E. F. M
    A high standard ABS TRA of Maternal and Child Health (MCH) and Family Planning (FP) services in a given society is a pre-requisite for better maternal care in pregnancy and through the perinatal period. Availability and extension of integrated MCH (1= services in the peripheral rural areas, is therefore, a basic precondition for the reduction of perinatal and infant mortality rates. In this preliminary report, bio-social characteristics pregnant women, pregnancy outcomes and factors related to the mothers and newborn infants, which contribute to perinatal mortality (PNM) in the study area in Nzega District are presented. The perinatal mortality study was started on first December 1987. By 31st May, 1988, over the six months period, 112 pregnant women had been followed up from 28 weeks of gestation to delivery. Of these women 1062(94.8%) had singleton births, while 58 (5.2%) women had twin pregnancies. The women were drawn from 25 villages with a population of about 58000 people. The crude birth rate in the study area over the period under observation was 39/1000 compared to 43/100 calculated for Tabora Region in 1978. The overall perinatal mortality rate (PNMR) was 72.5 per 100 total births. Late fetal wastage was 25.4/1000 births, while early neonatal mortality was 48.3/1000 live births. There were three cases of immediate maternal death, which gave a maternal mortality rate of 2.8/1000 births. Risk factors associated with increased perinatal mortality rate were found to be low birth weight, prematurity pregnancies, extreme maternal age and parity, poor antenatal attendance and traditional drugs usage. Other significant factors are malaria and febrile episodes during pregnancy, anaemia, a history of previous abortion, caesarian sections, breech extraction, assisted deliveries and poor maternal nutritional status. Negative weight gain after 28 weeks of gestation was found to be associated with increased late fetal mortality rate, but its effect on early neonatal death or total perinatal mortality was not statistically significant. On the other hand marital and literacy status and family planning practices were not significantly associated with perinatal outcome. Also a history of previous stillbirth, increased maternal workload and place of delivery were not found to significantly influence perinatal mortality rate in this study. In order to reduce perinatal mortality and to improve maternal and child care in the study area, it is recommended, among other things, that primary health care providers of MCH/FP services in peripheral rural health units must be given on the job training and increased supervision so as to improve their capability in identifying women at risk who need timely and expert attention at a referral hospital, and to increase their expertise in attending births and in post-natal care.