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Tachiweyika Emmanuel, Gombe Notion, Shambira Gerald, Chadambuka Addmore, Tshimamga Mufuta, Zizhou Simukai. Determinants of perinatal mortality in Marondera district, Mashonaland East Province, Zimbabwe, 2009: a case control study. The Pan African Medical Journal. 2011;8:7 Key words: Perinatal mortality, determinants, neonatal death Permanent link: http://www.panafrican-med-journal.com/content/article/8/7/full Received: 07/01/2011 - Accepted: 01/01/2011 - Published: 02/02/2011 © Tachiweyika Emmanuel et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
Determinants of perinatal mortality in Marondera district, Mashonaland East Province of Zimbabwe, 2009: a case control study
Tachiweyika Emmanuel1,&, Gombe Notion1, Shambira Gerald1, Chadambuka Addmore1, Tshimamga Mufuta1, Zizhou Simukai2
1University of Zimbabwe, Department of Community Medicine PO Box A178 Avondale Harare, Zimbabwe, 2Ministry of Health and Child Welfare, Zimbabwe
&Corresponding author
University of Zimbabwe, Department of Community Medicine PO Box A178 Avondale Harare, Zimbabwe
Background
Marondera District recorded perinatal mortality ratios of 58.6/1000 and 64.6/1000 live births in 2007 and 2008 respectively. These ratios were above provincial averages of 32/1000 and 36/1000 during the same periods. We determined factors associated with perinatal mortality in Marondera District.
Methods
A 1:2 unmatched case control study was carried out from June to August 2009. A case was any mother in Marondera District who had a stillbirth or early neonatal death from 01/08/2008 to 31/07/2009. A control was any mother whose baby survived the perinatal period during the same period. We calculated Odds Ratios and their 95% confidence intervals.
Results
We interviewed 103 cases and 206 controls. Primary or no maternal education [OR=5.50 (3.14-9.33)] labor complications [OR=7.56 (4.38-13.06)], home delivery [OR=7.38 (4.03-13.68)] and preterm delivery [OR=15.06 (8.24-27.54)] increased the risk for perinatal mortality. Antenatal care booking [OR=0.19 (0.10-0.34)], having a gainfully employed husband [OR=0.36 (0.20-0.63)] and living within 5km of a health facility [OR=0.41 (0.22-0.78)] reduced the risk. Independent determinants of perinatal mortality included being apostolic [AOR=3.11 (1.05-9.18)], having a home delivery [AOR 7.17 (2.48-20.73)], experiencing labor complications [AOR=8.99 (3.11-25.98)], maternal HIV infection [AOR=5.36 (2.02-14.26)], antenatal care booking [AOR=0.32 (0.18-0.87)] and birth weight below 2500g [AOR=9.46 (3.91-27.65)].
Conclusion
Labor complications, belonging to apostolic sect, having a home delivery, maternal HIV infection, low birth weight and antenatal care booking were independently associated with perinatal mortality. Health worker training in emergency management of obstetric and neonatal care was initiated. Marondera District started holding perinatal mortality meetings.
