Effective Factors on Perinatal Mortality in Rafsanjan Hospitals (2004-2006)

Perinatal mortality is used as an indicator for evaluation of adequate perinatal and care services. Awareness of the major causes and effective factors on perinatal mortality play an important role in botl strengthening of obstetric services and in perinatal care planning (from pregnancy to birth and to neonatal care). The purpose of this study was to identify the effective factors on perinatal mortality in Rafsanjan city population. This descriptive study was done on 321 cases of perinatal death over 2 years period. For each case, one baby who was living up to the 28th day after brith and it's age was the closest to the case, has chosen as the control group. Data was obtained from hospital records also by interview with the nurse, mother and obstetrician (or the person who delivered the baby). Data were analyzed by chi-square and t- tests. Perinatal mortality rate was 32.2 per 1000 (29.1 and 34.9 per 1000 for girls and boys, respectively). The most common causes of newborn mortality were prematurity (%53.8), respiratory distress syndrome (%20.5), septicemia (%6.4) and the common causes of stillbirth were premature rupture of amniotic membrane (%27.7), pregnancy induced hypertension (%8.9), placenta abruptio (%6.3) and congenital abnormality (%5.4). Statistical tests showed a significant relationship between the fetal weight, gestational age, history of stillbrith and birth rank with stillbirth. Twin births, maternal age, previous maternal disease, maternal weight gain during pregnancy and the number of pregnancy were among the risk factors that increased the newborn mortality rate. According to the findings, several reasons such as maternal age, birth grade, the average of gestational age, history of stillbirth, birth weight and primigravida play important role in occurrence of perinatal mortality. High priorities should be given to the strengthening and improvement of the obstetric services and initiating preventive efforts for above mentioned causes of prinatal mortality.