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Labour complications remain the most important risk factors for perinatal mortality in rural Kenya
Authors:Weiner Renay  Ronsmans Carine  Dorman Ed  Jilo Hilton  Muhoro Anne  Shulman Caroline
Institution:School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. weinerr@sph.wits.ac.za
Abstract:OBJECTIVES: To identify and quantify risk factors for perinatal mortality in a Kenyan district hospital and to assess the proportion of perinatal deaths attributable to labour complications, maternal undernutrition, malaria, anaemia and human immunodeficiency virus (HIV). METHODS: A cross-sectional study of 910 births was conducted between January 1996 and July 1997 and risk factors for perinatal mortality were analysed. FINDINGS: The perinatal mortality rate was 118 per 1000 births. Complications of labour such as haemorrhage, premature rupture of membranes/premature labour, and obstructed labour/ malpresentation increased the risk of death between 8- and 62-fold, and 53% of all perinatal deaths were attributable to labour complications. Placental malaria and maternal HIV, on the other hand, were not associated with perinatal mortality. CONCLUSIONS: Greater attention needs to be given to the quality of obstetric care provided in the rural district-hospital setting.
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