The current pattern of facility-based perinatal and neonatal mortality in Sagamu, Nigeria

Abstract

Background: Perinatal and neonatal mortality rates have been described as sensitive indices of the quality of health care services. Regular audits of perinatal and neonatal mortalities are desirable to evaluate the various global interventions. The objective was to describe the current pattern of perinatal and neonatal mortality in a Nigerian tertiary health facility. Materials and Methods: Using a prospective audit method, the sociodemographic parameters of all perinatal and neonatal deaths recorded in a Nigerian tertiary facility between February 2017 and January 2018 were studied. Results: There were 1019 deliveries with stillbirth rate of 27.5/1000 total births and early neonatal death (END) rate among in-born babies of 27.2/1000 live births. The overall perinatal mortality rate for in-facility deliveries was 53.9/1000 total births and neonatal mortality (till 28 days of life) rate of 27.2/1000 live births. Maternal characteristics included unbooked status (88.2%), at least secondary education (75%) and lower socioeconomic status (80.8%). Severe perinatal asphyxia (36.8%), prematurity (36.8%), severe hyperbilirubinaemia (8.8%), congenital malformations (5.9%) and tetanus (2.9%) were the causes of neonatal deaths while obstructed labour (25.0%) and intra-partum eclampsia (21.4%) were the two leading maternal conditions associated with stillbirths. Gestational age < 32 weeks, age < 24 hours and inborn status were significantly associated with END (p = 0.002, p <0.001 and p = 0.002 respectively). Conclusion: The intra-facility perinatal mortality rate was high though stillbirth rate was relatively low. This poses a challenge for the achievement of the Sustainable Development Goals in Nigeria.