Perinatal mortality in Azadi teaching hospital, Dohuk city, Iraq

ABSTRACT

Still birth and perinatal mortality has always been a major problematic issue in clinical practice. They are devastating experience for the parents specially the mother. Few local studies have addressed these problems. Estimation of the perinatal mortality rate and studying the major local etiological and predisposing factors in order to highlight the preventive strategies and form a base for future plans. A descriptive study was carried out for all perinatal deaths from 1st January to 31st December 2004 at Azadi teaching hospital in Dohuk city, Kurdistan region, Iraq. During the study period, the number of total births recorded was 10879. There were 427 perinatal deaths giving a perinatal mortality rate of 39.2 per 1000 births. The ratio of fresh stillbirths to macerated cases was 2/1 [126 and 60] respectively. The direct leading causes behind fresh stillbirths were placental abruption [25.4%], pre-eclampsia [16.7%], and congenital anomalies [14.3%]. The main causes of maceration were pre-eclampsia [33.3%], diabetes mellitus [21.6%] and congenital anomalies [20%]. Prematurity [46.9%], birth asphyxia [19.9%] and congenital anomalies [12.4%] were strongly associated with early neonatal deaths [241 cases]. A significantly higher risk of perinatal death was observed among women under 20 or over 40 years of age, grand-multiparity, low socioeconomic status, and poor antenatal care attendance. The profile of perinatal deaths among the studied group suggests the need for improvement in obstetric care, early referral, and availability of advanced neonatal care services including neonatal screening protocols