Perinatal morbidity and mortality among babies born to women attending Antenatal clinic at Naivasha District Hospital

Abstract

Background: Perinatal mortality, defined as death occurring after 28 weeks gestation up to one week of life, remains the biggest contributor to infant mortality. The magnitude of mortality in Kenya is mostly described using hospital derived data. Given that only an estimated 40% of women attending antenatal clinics in Kenya deliver in hospital, it is possible that the most of these mortalities therefore go unreported. This study was conducted in Naivasha, a town with a large peri-urban and rural catchment, with a unique cosmopolitan and predominantly farming population. It targeted pregnant women attending the antenatal clinic in order to capture all birth outcomes regardless of where they occurred. Objectives: The primary objective was to determine the prevalence of perinatal mortality and early neonatal morbidity of babies born to women attending Antenatal clinic at Naivasha District Hospital. The secondary objective was to determine the risk factors for perinatal mortality and early neonatal morbidity of babies born to women attending the clinic. The risk factors included maternal pregnancy complications, circumstances of delivery and signs of early neonatal illness. Methods: Pregnant women attending the antenatal care clinic who were of 28 weeks gestation and beyond were recruited consecutively during their regular antenatal attendance. They were then followed up on phone to find out the outcome of their pregnancy at the end of one week post-delivery. All mortality and morbidity events in the baby were recorded using a checklist modified from the WHO verbal autopsy questionnaire. Findings: A total of 197 were recruited into the study. Overall there were 7(3.5%) deaths, with 4(2.0%) stillbirths and 3 (1.5%) neonatal deaths in the first week of life. The perinatal mortality was 3.5% and 57% of these deaths were still births. Twelve 12 (7.5%) babies had morbidity severe enough to warrant medical treatment or hospitalization. Early neonatal morbidity was associated with increasing maternal age, previous history of perinatal mortality, rupture of membranes longer than 12 hours and labour duration longer than 12 hours. Prematurity and inability to breastfeed were associated increased mortality. Mothers with a previous history of perinatal death were also at risk of losing their babies. Conclusion: There was a high perinatal mortality compared to the national average. Most of the deaths were still births.