Causes of perinatal mortality and associated maternal complications in a South African province : challenges in predicting poor outcomes

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dc.contributor.author Allanson, Emma R.
dc.contributor.author Muller, Mari
dc.contributor.author Pattinson, Robert Clive
dc.date.accessioned 2015-06-24T05:22:08Z
dc.date.available 2015-06-24T05:22:08Z
dc.date.issued 2015-02-15
dc.description.abstract BACKGROUND: Reviews of perinatal deaths are mostly facility based. Given the number of women who, globally, deliver outside of facilities, this data may be biased against total population data. We aimed to analyse population based perinatal mortality data from a LMIC setting (Mpumalanga, South Africa) to determine the causes of perinatal death and the rate of maternal complications in the setting of a perinatal death. METHODS : A secondary analysis of the South African Perinatal Problems Identification Program (PPIP) database for the Province of Mpumalanga was undertaken for the period October 2013 to January 2014, inclusive. Data on each individual late perinatal death was reviewed. We examined the frequencies of maternal and fetal or neonatal characteristics in late fetal deaths and analysed the relationships between maternal condition and fetal and/or neonatal outcomes. IBM SPSS Statistics 22.0 was used for data analysis. RESULTS : There were 23503 births and 687 late perinatal deaths (stillbirths of ≥ 1000gr or ≥ 28 weeks gestation and early neonatal deaths up to day 7 of neonatal life) in the study period. The rate of maternal complication in macerated stillbirths, fresh stillbirths and early neonatal deaths was 50.4%, 50.7% and 25.8% respectively. Mothers in the other late perinatal deaths were healthy. Maternal hypertension and obstetric haemorrhage were more likely in stillbirths (p = <0.01 for both conditions), whereas ENNDs were more likely to have a healthy mother (p < 0.01). The main causes of neonatal death were related to immaturity (48.7%) and hypoxia (40.6%). 173 (25.2%) of all late perinatal deaths had a birth weight less than the 10th centile for gestational age. CONCLUSION : A significant proportion of women have no recognisable obstetric or medical condition at the time of a late perinatal death; we may be limited in our ability to predict poor perinatal outcome if emphasis is put on detecting maternal complications prior to a perinatal death. Intrapartum care and hypertensive disease remain high priority areas for addressing perinatal mortality. Consideration needs to be given to novel ways of detecting growth restriction in a LMIC setting. en_ZA
dc.description.librarian am2015 en_ZA
dc.description.uri http://www.biomedcentral.com/bmcpregnancychildbirth en_ZA
dc.identifier.citation Allanson, ER, Muller, M & Pattinson, RC 2015, 'Causes of perinatal mortality and associated maternal complications in a South African province : challenges in predicting poor outcomes', BMC Pregnancy and Childbirth, vol. 15, no. 37, pp. 1-7. en_ZA
dc.identifier.issn 1471-2393
dc.identifier.other 10.1186/s12884-015-0472-9
dc.identifier.uri http://hdl.handle.net/2263/45692
dc.language.iso en en_ZA
dc.publisher BioMed Central en_ZA
dc.rights © 2015 Allanson et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License. en_ZA
dc.subject Perinatal mortality (PM) en_ZA
dc.subject Maternal complication en_ZA
dc.subject Growth restriction en_ZA
dc.subject Hypertension en_ZA
dc.subject Intrapartum care en_ZA
dc.title Causes of perinatal mortality and associated maternal complications in a South African province : challenges in predicting poor outcomes en_ZA
dc.type Article en_ZA


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