Perinatal mortality--report of a hospital based study.

The perinatal mortality rate (PNMR) per 1000 births is reported in 27,394 consecutive births. It was 75.6, of which 40.0 were neonatal deaths and 35.6 were fetal losses. The PNMR was significantly higher at the two extremes of maternal age, in parity five and above, and with a previous history of fetal or neonatal loss. Other maternal contributing factors were antepartum haemorrhage, hydramnios and infections. One-third of the babies weighed 2500 g or less. The PNMR dropped precipitously from 340.48 in the birth weight group 1501 to 2000 g, to 46.6 in the group 2001 to 2500 g, indicating a cut-off point at 2000 g for a baby at high risk needing special care. The common necropsy causes of death were asphyxia (24.33%), pulmonary conditions (20.02%), congenital malformations (13.6%), and infections (6.19%). No cause of death could be detected at necropsy in 22.12% and no clinico-pathological cause of death could be assigned in 26.76% of deaths. A majority of deaths due to asphyxia could have been prevented by better antenatal and intranatal care. Low birth weight was an important cause of perinatal deaths, and better maternal nutrition and antenatal care could play an important role in reducing this.