Causes Of Perinatal Mortality In Public Secondary Health Facilities In Port Harcourt, Nigeria: A 3-Year Retrospective Review

Background: Perinatal mortality (PM) remains a major public health problem in developing countries with multifaceted consequences. Epidemiological data on perinatal deaths among secondary health facilities in Nigeria is scarce and this study aimed to determine the Perinatal Mortality Rate (PMR) and associated risk factors in public secondary health facilities in Rivers State.

Method: A retrospective review of case records was conducted from 2018 to 2020 at Obio Cottage Hospital and Military Hospital, Port Harcourt, Nigeria. Data extracted were analysed using IBM SPSS version 23. P-value < 0.05 was considered significant. The chi-square test was used to identify associations between perinatal mortality and the presence of maternal comorbid conditions.

Results: Of 12,894 births there were 207 (Stillbirths and Early Neonatal Deaths) giving a PMR of 16.1 [CI:16.045 – 16.152] per 1000 total births. There was a slight increase in PMR from 15.1 per 1000 in 2018 to 17.3 per 1000 in 2020 (p=0.737). Perinatal asphyxia (54.5%), prematurity (18.2%) and respiratory distress syndrome (27.3%) were the leading causes of perinatal mortality. Mothers with comorbid conditions had 2.5 [CI: 1.9 – 3.3] times higher odds of perinatal deaths. The top six maternal comorbid conditions were hypertension (14.61%) and antepartum haemorrhage (13.48%), postdate pregnancy and ruptured uterus (11.24%) each, cord prolapse and preterm labour (10.11%) each.

Conclusion: Perinatal mortality is relatively high in public secondary health facilities in Port Harcourt.
Interventions targeted at reducing identified risk factors like early ANC booking and early obstetric interventions should be encouraged.