Perinatal mortality statistics in Harare 1980-1989
Iliff, P.J.; Kenyon, N.
Central African Journal of Medicine 37(5): 133-136
1991
ISSN/ISBN: 0008-9176 PMID: 1790552 Document Number: 321385
Physicians used birth data on all neonatal and fetal deaths between 1980-89 submitted by the City Health Department, Harare Maternity Hospital, and 10 Harare City Clinics to determine various perinatal mortality rates. all the rates fell in the beginning of the 1980s: neonatal mortality rate (NNMR) 17-15 (1980-85), perinatal mortality rate (PMR) 40-35 (1980-85), fetal death rate (FDR) 21-20 (1983-85), and PMR for booked patients (bPMR) 26-24 (1981-85). Between 1986-89, however, all the rates increased; NNMR 19-23, PMR 41-47, FDR 24-26, and bPMR 25-38. There was a 53% rise in the NNMR and a 30% rise in the PMR. Deaths among neonates 1000gm accounted for 50% of the increase in NNMR. Prematurity was responsible for these deaths. They constituted the birth category with the most considerable increase in the proportion of deaths among all births after 1985 (3.5-8/1000 live births). In 1985, out of about 130 total births of neonates weighing 1000gm 45 infants survived compared with 20 out of about 235 such births in 1987. Deaths among neonates 2500gm increased steadily after 1985 (4-6) and were responsible for 25% of the increase in the NNMR. The major cause of death among the large neonates was birth asphyxia. The physicians proposed 2 testable hypotheses for the increases: demographic changes in mothers and rising prevalence of HIV infection. Other possible reasons included inadequate number of midwives and anesthetists, lack of electronic fetal heart rate monitors, and poor morale among nurses and junior medical staff. The physicians recommended that a broad-base investigation or a series of investigations into the reasons for these increases begin soon, e.g., the creation of a National Perinatal Epidemiology Unit and community-base studies. Data should include births at private maternity clinics, births assisted by traditional birth attendants, and home births.