Stillbirth and early neonatal mortality in rural Central Africa.
OBJECTIVE
To develop a prospective perinatal registry that characterizes all deliveries, differentiates between stillbirths and early neonatal deaths (ENDs), and determines the ratio of fresh to macerated stillbirths in the northwest Democratic Republic of Congo.


METHODS
Birth outcomes were obtained from 4 rural health districts.


RESULTS
A total of 8230 women consented, END rate was 32 deaths per 1000 live births, and stillbirth rate was 33 deaths per 1000 deliveries. The majority (75%) of ENDs and stillbirths occurred in neonates weighing 1500 g or more. Odds of stillbirth and END increased in mothers who were single or who did not receive prenatal care, and among premature, low birth weight, or male infants. The ratio of fresh to macerated stillbirths was 4:1.


CONCLUSIONS
Neonates weighing 1500 g or more at birth represent a group with a high likelihood of survival in remote areas, making them potentially amenable to targeted intervention packages. The ratio of fresh to macerated stillbirths was approximately 10-fold higher than expected, suggesting a more prominent role for improved intrapartum obstetric interventions.
Engmann
Cyril
C
University of North Carolina at Chapel Hill, North Carolina 27599-7596, USA. cengmann@med.unc.edu
Matendo
Richard
R
Kinoshita
Rinko
R
Ditekemena
John
J
Moore
Janet
J
Goldenberg
Robert L
RL
Tshefu
Antoinette
A
Carlo
Waldemar A
WA
McClure
Elizabeth M
EM
Bose
Carl
C
Wright
Linda L
LL
D000328:Adult; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D054238:Perinatal Mortality; D011247:Pregnancy; D011446:Prospective Studies; D012042:Registries; D012424:Rural Population; D050497:Stillbirth / Q000453:epidemiology*