Distribution and Determinants of Perinatal Mortality in Jammu City of India

Giving birth is not a pathological phenomenon and newborn is not a disease; still in underdeveloped and developing countries, large number are born dead or die soon after birth, many of them during the first week (early neonatal deaths). For every baby who dies in the first week after birth, another is born dead (fetal deaths or stillbirths).

To find out the incidence of Perinatal Mortality Rate (PNMR), and it's co-relations with different socio-demographic factors, obstetric complications and other diseases during pregnancy. To address these factors so as to reduce PNMR.

A community based prospective cohort study was conducted in Jammu city of J&K state. In all 806 eligible pregnant women were enrolled and followed from 22nd week of gestation till 28 days after delivery so as to find out the incidence of still births (SB) and early neonatal mortality rate (ENNMR) and late neonatal mortality rate (LNNMR). The study lasted for one complete year from 1st January 2011 to 31st December 2011. The relationship of perinatal mortality (still births + early neonatal deaths) with age of mother, parity, malnutrition (anemia), faetal-presentation, type of delivery and other obstetric complications as well as with diseases was studied. The results were statistically analyzed applying SPSS version 17.

Of the total 806 births, 94.8% were live births, 1.4% still births, 3.3% early neonatal deaths, 4.7% perinatal deaths, 0.5% late neonatal deaths and 3.8% were neonatal deaths. Association of age distribution of mother to perinatal and neonatal mortality was “U” shaped in distribution; highest in the teen age and 40 - 49 age groups. This association was found to be significant (p = 0.04 at 95% CI). Association of parity of mother with PNMR and NNMR was significant (p = 0.02 at 95%CI). PNMR and NNMR was higher in males as compared to female neonates and association was significant (p = 0.03 at 95% CI). Relationship of maternal education and mortalities was not significantly associated (p = 0.97 at 95% CI); however association of income and PNMR and NNMR were highly significant (p = 0.002 at 99% CI). Similarly anemia and PNMR and NNMR were also significantly associated (p = 0.03 at 99% CI). Association of birth weight and mortalities under study was highly significant (p = 0.001 at 99% CI). Association of indirect causes was insignificant (p = 0.47at 68%CI). Relationship of type of delivery and intra-natal causes with these mortalities was highly significant (p = 0.001 at 99%CI and P = 0.01 at 99% CI respectively).

PNMR and NNMR are significantly associated with maternal age, parity, socio-economic status, obstetric complications, communicable and non-communicable diseases as well as with birth weight. These are mostly avoidable determinants so as to reduce these mortalities.