245958 Stillbirths and early neonatal mortality in rural northern Ghana

Monday, October 31, 2011: 3:10 PM

Cyril M. Engmann, MD FAAP , Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina Schools of Medicine and Public Health, Chapel Hill, NC
Paul Walega, MSc , Ghana Health Service, Navrongo Health Research Center, Navrongo, Ghana
Raymond Aborigo, MPH , Ghana Health Service, Navrongo Health Research Center, Navrongo, Ghana
Philip Adongo, PhD , Deparment of Community and Behavioral Medicine, University of Ghana, Accra, Ghana
Cheryl Moyer, MPH , Global REACH, University of Michigan Medical School, Ann Arbor, MI
Layla Lavasani, MHS , Department of Maternal and Child Health, UNC Gillings School of Public Health, Chapel Hill, NC
John Williams, MD , Ghana Health Service, Navrongo Health Research Center, Navrongo, Ghana
Carl Bose, MD FAAP , Department of Pediatrics, University of North Carolina, Chapel Hill, NC
Fred Binka, MD , School of Public Health, University of Ghana, Accra, Ghana
Abraham Hodgson, MD, PhD , Ghana Health Service, Navrongo Health Research Center, Navrongo, Ghana
     
Objective: To calculate perinatal mortality (stillbirth and early neonatal death: END) rates in the Upper East region of Ghana and characterize community-based stillbirths and END in terms of timing, cause of death, and maternal and infant risk factors. Method: Birth outcomes were obtained from the Navrongo Health and Demographic surveillance system over a 7-year period. Results: 20,497 pregnant women were registered in the study. The perinatal mortality rate was 39 deaths/1000 deliveries, stillbirth rate 23/1000 deliveries, and END rates 16/1000 live births. Most stillbirths were 31 weeks gestation or less and almost all occurred at home. Maternal age below 25 years, prematurity, and multiple gestation all significantly increased the odds of perinatal death. Approximately 70% of END occurred during the first 3 postnatal days, and the most common causes of death were birth asphyxia and injury, infections and prematurity. Conclusions: Stillbirths and END remain a significant problem in Navrongo. The main causes of END occur during the first 3 days and may be modifiable with simple targeted perinatal policies.

Learning Areas:
Epidemiology
Public health or related research

Learning Objectives:
Participants will be able to: 1) Describe the difference between stillbirth, early neonatal mortality, neonatal mortality, and infant mortality 2) List key predictors of stillbirths in rural northern Ghana 3) List key predictors of early neonatal deaths in rural northern Ghana

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a practicing Neonatologist, a consultant to the World Health Organization, and Principal Investigator on this study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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