Sociodemographic characteristics and perinatal mortality among singletons in North East Tanzania: a registry-based study.
OBJECTIVE
Sub-Saharan Africa has the highest known perinatal mortality rates in the World, but few studies have assessed the importance of parental sociodemographic characteristics on perinatal mortality in this region. The aim of this study was to estimate how sociodemographic patterns affect perinatal mortality in Northern Tanzania.


METHODS
A registry-based study using births from 1999 to 2006 at a hospital in North Eastern Tanzania.


METHODS
14 394 singleton births with birthweight 500 g or higher and a known perinatal survival status. Births of women with residence outside the local district who were referred to the hospital for delivery for medical reasons were excluded.


RESULTS
Perinatal mortality was 41.1 per 1000 births. Factors independently associated with higher perinatal mortality were: higher paternal age (> 45) compared to age 26-35 (adjusted relative risk (ARR) 2.0; 95% CI 1.4 to 2.8), low paternal education (only primary) compared to secondary or higher (ARR 1.3; 95% CI 1.1 to 1.7), paternal ethnicity other than Chagga or Pare (ARR 1.4; 95% CI 1.1 to 1.7), paternal farming occupation (ARR 1.5; 95% CI 1.1 to 2.2), maternal service occupation (ARR 1.7; 95% CI 1.2 to 2.6), maternal height 150 cm or lower (ARR 1.4; 95% CI 1.0 to 1.8) and residence in the rural or semi-urban area (ARR 1.4; 95% CI 1.1 to 1.7).


CONCLUSIONS
There are strong sociodemographic gradients in perinatal mortality in Africa. Paternal social characteristics appear to have stronger influence on perinatal mortality than maternal characteristics. This may reflect social and cultural conditions that need to be considered by policymakers in developing countries.
Department of Public Health and Primary Health Care, University of Bergen, Norway. ndema_h@yahoo.com
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D000293:Adolescent; D000328:Adult; D005220:Fathers / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008423:Maternal Age; D009035:Mothers / Q000706:statistics & numerical data; D010331:Paternal Age; D054238:Perinatal Mortality / Q000639:trends*; D012042:Registries; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D013636:Tanzania / Q000453:epidemiology; D014504:Urban Health; D055815:Young Adult