Department of Nursing and Midwifery, Faculty of Health Sciences, Lira University , Lira, Uganda.
Department of Paediatrics and Child Health, School of Medicine, Makerere University College of Health Sciences , Kampala, Uganda.
Glob Health Action. 2021 Jan 1;14(1):1859823. doi: 10.1080/16549716.2020.1859823.
: Perinatal mortality in Uganda remains high at 38 deaths/1,000 births, an estimate greater than the every newborn action plan (ENAP) target of ≤24/1,000 births by 2030. To improve perinatal survival, there is a need to understand the persisting risk factors for death. : We determined the incidence, risk factors, and causes of perinatal death in Lira district, Northern Uganda. : This was a community-based prospective cohort study among pregnant women in Lira district, Northern Uganda. Female community volunteers identified pregnant women in each household who were recruited at ≥28 weeks of gestation and followed until 50 days postpartum. Information on perinatal survival was gathered from participants within 24 hours after childbirth and at 7 days postpartum. The cause of death was ascertained using verbal autopsies. We used generalized estimating equations of the Poisson family to determine the risk factors for perinatal death. : Of the 1,877 women enrolled, the majority were ≤30 years old (79.8%), married or cohabiting (91.3%), and had attained only a primary education (77.7%). There were 81 perinatal deaths among them, giving a perinatal mortality rate of 43/1,000 births [95% confidence interval (95% CI: 35, 53)], of these 37 were stillbirths (20 deaths/1,000 total births) and 44 were early neonatal deaths (23 deaths/1,000 live births). Birth asphyxia, respiratory failure, infections and intra-partum events were the major probable contributors to perinatal death. The risk factors for perinatal death were nulliparity at enrolment (adjusted IRR 2.7, [95% CI: 1.3, 5.6]) and maternal age >30 years (adjusted IRR 2.5, [95% CI: 1.1, 5.8]). : The incidence of perinatal death in this region was higher than had previously been reported in Uganda. Risk factors for perinatal mortality were nulliparity and maternal age >30 years. Pregnant women in this region need improved access to care during pregnancy and childbirth.
乌干达的围产期死亡率仍然很高，为每 1000 例活产 38 例死亡，这一估计值高于 2030 年每新生儿行动计划（ENAP）的目标值，即每 1000 例活产 ≤24 例死亡。为了提高围产期生存率，需要了解持续存在的死亡风险因素。
我们在乌干达北部的利拉区确定了围产期死亡的发生率、风险因素和原因。
这是一项在利拉区进行的基于社区的前瞻性队列研究，研究对象为该地区的孕妇。女性社区志愿者在每个家庭中确定孕妇，招募≥28 周妊娠的孕妇，并随访至产后 50 天。在分娩后 24 小时内和产后 7 天内从参与者那里收集围产期生存信息。通过口头尸检确定死因。我们使用泊松家族的广义估计方程来确定围产期死亡的风险因素。
在登记的 1877 名妇女中，大多数年龄在 30 岁以下（79.8%）、已婚或同居（91.3%），仅接受过小学教育（77.7%）。其中有 81 例围产期死亡，围产期死亡率为 43/1000 例[95%置信区间（95%CI：35，53)]，其中 37 例为死产（每 1000 例总出生 20 例死亡），44 例为早期新生儿死亡（每 1000 例活产 23 例死亡）。出生窒息、呼吸衰竭、感染和分娩期事件是围产期死亡的主要可能原因。围产期死亡的风险因素是登记时的初产（调整后的发病率比 2.7，[95%CI：1.3，5.6]）和母亲年龄 >30 岁（调整后的发病率比 2.5，[95%CI：1.1，5.8]）。
该地区的围产期死亡率高于乌干达以前的报告。围产期死亡的风险因素是初产和母亲年龄 >30 岁。该地区的孕妇需要在怀孕期间和分娩期间获得更好的护理。
