Objective: To determine perinatal mortality rates and associated socio-demographic factors in two rural districts in Zimbabwe.
Design: Cross sectional community based survey.
Setting: Murewa and Madziwa rural districts.
Subjects: Women aged 15 to 50 years who had been pregnant over the preceding two years before the study.
Materials and methods: A questionnaire was administered to eligible women by trained interviewers. Information pertaining to the women's socio-demographic characteristics, reproductive health profile and pregnancy outcome was documented. A post hoc case control analysis was undertaken to determine the risk factors associated with poor perinatal outcome. Women who had a poor perinatal outcome were designated cases and those with a good outcome were designated controls.
Results: The average perinatal mortality rate for both districts was 111 per 1,000 live births (Murewa 182 per 1,000 and Madziwa 48 per 1,000). Factors significantly associated with perinatal mortality were ethnicity, marital status, subjective standard of living and the women's level of formal education. Being Zezuru or being married was associated with poor perinatal outcome. Living well and having high levels of education were also associated with poor perinatal outcome. Perinatal mortality was not significantly associated with maternal age or spouse level of education.
Conclusion: This study showed unacceptability high perinatal mortality rates in these rural districts. The true socio-demographic factors associated with perinatal mortality could not be ascertained in this study because of confounding factors. There is need to study quality of antenatal, intrapartum and neonatal care offered by health centres in these districts. In addition there is need to strongly advocate a perinatal programme to address these high mortality rates.
PIP: A community-based survey of 640 women 15-50 years old who had been pregnant in the 2 years preceding the study was conducted in two rural districts in Zimbabwe (Murewa and Madziwa) to assess perinatal mortality and the associated sociodemographic factors. The overall perinatal mortality rate was 111/1000 live births (182/1000 in Murewa and 48/1000 in Madziwa). Murewa had significantly more stillbirths, abortions, and perinatal and infants deaths than Madziwa. A perinatal death was 1.94 times more likely if the woman was from the Zezuru ethnic group. Single, separated, divorced, and widowed women had better pregnancy outcomes than married women (polygamous or monogamous). Finally, living well (subjectively assessed) and a high educational level (completion of primary school and above) were both associated with significant risks of poor perinatal outcomes. Maternal age and inter-birth interval were not risk factors. Because of lack of controls for confounding, the generally puzzling risk factors identified in this study require confirmation. However, the high mortality rate identified in this study indicates an urgent need for implementation of effective perinatal programs in this area.