Perinatal mortality in Lagos University Teaching Hospital: a five year review.

BACKGROUND: An overwhelming proportion of the annual global perinatal deaths occur in developing countries. However few data on perinatal mortality are available from these countries. Reducing perinatal deaths requires adequate data that can be used to develop appropriate strategies. OBJECTIVES: To determine the perinatal mortality rate at the Lagos University Teaching Hospital (LUTH), the associated risk factors and the causes of perinatal deaths; and make recommendations to help reduce perinatal mortality. METHODS: A retrospective study of all deliveries in LUTH in the period between January 2002 and December 2006 was done. Data were collected on all stillbirths and early neonatal deaths. Analysis included such variables as booking status, maternal age, parity, gestational age, fetal weight and cause of perinatal death. RESULTS: The perinatal mortality rate was 70.6/1000 total births. The rate was higher among unbooked patients and those with multiple pregnancies. It increased with parity after the 2nd delivery and was highest at the extremes of reproductive age groups. The commonest causes of death were antepartum haemorrhage, pre-eclampsia/eclampsia, mechanical causes, intrapartum asphyxia and prematurity. CONCLUSIONS: The perinatal mortality rate in our institution is high. The causes of perinatal death are largely preventable. Urgent clinical and political actions are required to make any progress towards attaining the fourth millennium development goal (MDG4).