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Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study.
Arach, Anna Agnes Ojok; Tumwine, James K; Nakasujja, Noeline; Ndeezi, Grace; Kiguli, Juliet; Mukunya, David; Odongkara, Beatrice; Achora, Vincentina; Tongun, Justin B; Musaba, Milton W; Napyo, Agnes; Tylleskar, Thorkild; Nankabirwa, Victoria.
Afiliação
  • Arach AAO; Department of Nursing and Midwifery, Faculty of Health Sciences, Lira University , Lira, Uganda.
  • Tumwine JK; Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences , Kampala, Uganda.
  • Nakasujja N; Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences , Kampala, Uganda.
  • Ndeezi G; Department of Psychiatry, School of Medicine, Makerere University College of Health Sciences , Kampala, Uganda.
  • Kiguli J; Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences , Kampala, Uganda.
  • Mukunya D; Department of Community Health and Behavioural Sciences, School of Public Health, Makerere University, College of Health Sciences , Kampala, Uganda.
  • Odongkara B; Department of Research, Sanyu Africa Research Institute , Mbale, Uganda.
  • Achora V; Department of Public Health, Busitema University Faculty of Health Sciences , Mbale, Uganda.
  • Tongun JB; Department of Paediatrics and Child Health, Gulu University , Gulu, Uganda.
  • Musaba MW; Department of Obstetrics and Gynaecology, Gulu University , Gulu, Uganda.
  • Napyo A; Department of Paediatrics and Child Health, University of Juba , Juba, South Sudan.
  • Tylleskar T; Department of Obstetrics and Gynaecology, Busitema University Faculty of Health Sciences , Mbale, Uganda.
  • Nankabirwa V; Department of Public Health, Busitema University Faculty of Health Sciences , Mbale, Uganda.
Glob Health Action ; 14(1): 1859823, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33446087
ABSTRACT

Background:

Perinatal mortality in Uganda remains high at 38 deaths/1,000 births, an estimate greater than the every newborn action plan (ENAP) target of ≤24/1,000 births by 2030. To improve perinatal survival, there is a need to understand the persisting risk factors for death.

Objective:

We determined the incidence, risk factors, and causes of perinatal death in Lira district, Northern Uganda.

Methods:

This was a community-based prospective cohort study among pregnant women in Lira district, Northern Uganda. Female community volunteers identified pregnant women in each household who were recruited at ≥28 weeks of gestation and followed until 50 days postpartum. Information on perinatal survival was gathered from participants within 24 hours after childbirth and at 7 days postpartum. The cause of death was ascertained using verbal autopsies. We used generalized estimating equations of the Poisson family to determine the risk factors for perinatal death.

Results:

Of the 1,877 women enrolled, the majority were ≤30 years old (79.8%), married or cohabiting (91.3%), and had attained only a primary education (77.7%). There were 81 perinatal deaths among them, giving a perinatal mortality rate of 43/1,000 births [95% confidence interval (95% CI 35, 53)], of these 37 were stillbirths (20 deaths/1,000 total births) and 44 were early neonatal deaths (23 deaths/1,000 live births). Birth asphyxia, respiratory failure, infections and intra-partum events were the major probable contributors to perinatal death. The risk factors for perinatal death were nulliparity at enrolment (adjusted IRR 2.7, [95% CI 1.3, 5.6]) and maternal age >30 years (adjusted IRR 2.5, [95% CI 1.1, 5.8]).

Conclusion:

The incidence of perinatal death in this region was higher than had previously been reported in Uganda. Risk factors for perinatal mortality were nulliparity and maternal age >30 years. Pregnant women in this region need improved access to care during pregnancy and childbirth.
Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Estudo de etiologia / Estudo de incidência / Estudo observacional / Estudo prognóstico / Fatores de risco Idioma: Inglês Revista: Glob Health Action Ano de publicação: 2021 Tipo de documento: Artigo País de afiliação: Uganda

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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Tipo de estudo: Estudo de etiologia / Estudo de incidência / Estudo observacional / Estudo prognóstico / Fatores de risco Idioma: Inglês Revista: Glob Health Action Ano de publicação: 2021 Tipo de documento: Artigo País de afiliação: Uganda
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