Perinatal Mortality in Southern Nigeria; less than half a decade to the Millennium Developmental Goals

BACKGROUND: Perinatal mortality is one of the essential indicators of the health status of a country and by extension its state of development. Reduction in perinatal mortality rate is an important aspect of the MDGs. OBJECTIVES: To determine the perinatal mortality rate (PMR) in 2 tertiary institutions in Southern Nigeria and the factors responsible for the deaths. METHODS: This was a retrospective, observational study conducted amongst 2 groups of subjects (A and B) located in 2 tertiary hospitals in Southern Nigeria over a 2-year period (1(st) Jan 2004 to 31(st) Dec. 2005). Variables such as maternal age, socio-economic status of the parents, sex, gestational age at delivery, mode of delivery, birth-weight, and age of baby before death and probable cause of death were recorded. RESULTS: During the period, the perinatal mortality rate of 62.7/ 1000 live-births was recorded. The individual contributions to this rate were 22.1/1000 live births and 40.6/1000 live births for A and B respectively. The common causes of death in the study subjects were unbooked maternal status, fresh/macerated still births, low birth weight /premature babies and severe birth asphyxia. The mean gestational age for group A was 34.7 ± 6.50 wks and 33± 1.20 wks for group B, while the mean maternal ages were 27.3± 5.75yrs and 28.6 ± 5.1yrs respectively. Majority of the deliveries were by Spontaneous Vertex Delivery (SVD), accounting for 49.4% and 56% of the total deliveries in the two groups respectively. Furthermore, the male: female ratio was 0.85: 1.0 and 0.9: 1.0, the mean birth weights were 2.60 ± 1.87kg and 2.88 ±2.08kg and the unbooked cases were 61.9% and 70.6% respectively for group A and B. CONCLUSION: There is high rate of perinatal deaths in Southern Nigeria. This is associated with high rates of unbooked pregnancies resulting in difficult labours, ruptured uterus, chorio-amnionitis, preterm/low-birtthweight babies and severe neonatal asphyxia.