Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study
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 determ...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2021-01-01
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| Series: | Global Health Action |
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| Online Access: | http://dx.doi.org/10.1080/16549716.2020.1859823 |
| _version_ | 1819159248796385280 |
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| author | Anna Agnes Ojok Arach James K. Tumwine Noeline Nakasujja Grace Ndeezi Juliet Kiguli David Mukunya Beatrice Odongkara Vincentina Achora Justin B. Tongun Milton W. Musaba Agnes Napyo Thorkild Tylleskar Victoria Nankabirwa |
| author_facet | Anna Agnes Ojok Arach James K. Tumwine Noeline Nakasujja Grace Ndeezi Juliet Kiguli David Mukunya Beatrice Odongkara Vincentina Achora Justin B. Tongun Milton W. Musaba Agnes Napyo Thorkild Tylleskar Victoria Nankabirwa |
| author_sort | Anna Agnes Ojok Arach |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-22T16:37:33Z |
| format | Article |
| id | doaj.art-3f56ec463c3d4417ac2c1f87a83965e4 |
| institution | Directory Open Access Journal |
| issn | 1654-9880 |
| language | English |
| last_indexed | 2024-12-22T16:37:33Z |
| publishDate | 2021-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj.art-3f56ec463c3d4417ac2c1f87a83965e42022-12-21T18:19:55ZengTaylor & Francis GroupGlobal Health Action1654-98802021-01-0114110.1080/16549716.2020.18598231859823Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort studyAnna Agnes Ojok Arach0James K. Tumwine1Noeline Nakasujja2Grace Ndeezi3Juliet Kiguli4David Mukunya5Beatrice Odongkara6Vincentina Achora7Justin B. Tongun8Milton W. Musaba9Agnes Napyo10Thorkild Tylleskar11Victoria Nankabirwa12Lira UniversityMakerere University College of Health SciencesMakerere University College of Health SciencesMakerere University College of Health SciencesMakerere University, College of Health SciencesSanyu Africa Research InstituteGulu UniversityGulu UniversityUniversity of JubaBusitema University Faculty of Health SciencesBusitema University Faculty of Health SciencesUniversity of BergenMakerere University College of Health SciencesBackground: 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.http://dx.doi.org/10.1080/16549716.2020.1859823perinatal deathperinatal mortalityearly neonatal deathsrisk factorsuganda |
| spellingShingle | Anna Agnes Ojok Arach James K. Tumwine Noeline Nakasujja Grace Ndeezi Juliet Kiguli David Mukunya Beatrice Odongkara Vincentina Achora Justin B. Tongun Milton W. Musaba Agnes Napyo Thorkild Tylleskar Victoria Nankabirwa Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study Global Health Action perinatal death perinatal mortality early neonatal deaths risk factors uganda |
| title | Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study |
| title_full | Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study |
| title_fullStr | Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study |
| title_full_unstemmed | Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study |
| title_short | Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study |
| title_sort | perinatal death in northern uganda incidence and risk factors in a community based prospective cohort study |
| topic | perinatal death perinatal mortality early neonatal deaths risk factors uganda |
| url | http://dx.doi.org/10.1080/16549716.2020.1859823 |
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