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Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study

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 determ...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Taylor & Francis 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7832989/
https://www.ncbi.nlm.nih.gov/pubmed/33446087
http://dx.doi.org/10.1080/16549716.2020.1859823
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author 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
author_facet 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
author_sort Arach, Anna Agnes Ojok
collection PubMed
description 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.
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spelling pubmed-78329892021-02-02 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 Glob Health Action Original Article 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. Taylor & Francis 2021-01-15 /pmc/articles/PMC7832989/ /pubmed/33446087 http://dx.doi.org/10.1080/16549716.2020.1859823 Text en © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
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
Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study
title Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study
title_full Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study
title_fullStr Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study
title_full_unstemmed Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study
title_short Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study
title_sort perinatal death in northern uganda: incidence and risk factors in a community-based prospective cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7832989/
https://www.ncbi.nlm.nih.gov/pubmed/33446087
http://dx.doi.org/10.1080/16549716.2020.1859823
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