title: Stillbirth and early neonatal mortality in rural Central Africa.
abstract: 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.
authors.affiliation: University of North Carolina at Chapel Hill, North Carolina 27599-7596, USA. cengmann@med.unc.edu
authors.forename: Cyril
authors.initials: C
authors.lastname: Engmann
authors.forename: Richard
authors.initials: R
authors.lastname: Matendo
authors.forename: Rinko
authors.initials: R
authors.lastname: Kinoshita
authors.forename: John
authors.initials: J
authors.lastname: Ditekemena
authors.forename: Janet
authors.initials: J
authors.lastname: Moore
authors.forename: Robert L
authors.initials: RL
authors.lastname: Goldenberg
authors.forename: Antoinette
authors.initials: A
authors.lastname: Tshefu
authors.forename: Waldemar A
authors.initials: WA
authors.lastname: Carlo
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: McClure
authors.forename: Carl
authors.initials: C
authors.lastname: Bose
authors.forename: Linda L
authors.initials: LL
authors.lastname: Wright
mesh_terms: 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*