title: Perinatal mortality in rural Burkina Faso: a prospective community-based cohort study.
abstract: BACKGROUND
  There is a scarcity of reliable data on perinatal mortality (PNM) in Sub-Saharan Africa. The PROMISE-EBF trial, during which we promoted exclusive breastfeeding, gave us the opportunity to describe the epidemiology of PNM in Banfora Health District, South-West in Burkina Faso.
  
  
  OBJECTIVE
  To measure the perinatal mortality rate (PNMR) in the PROMISE-EBF cohort in Banfora Health District and to identify potential risk factors for perinatal death.
  
  
  METHODS
  We used data collected prospectively during the PROMISE-EBF-trial to estimate the stillbirth rate (SBR) and early neonatal mortality rate (ENMR). We used binomial regression with generalized estimating equations to identify potential risk factors for perinatal death.
  
  
  RESULTS
  895 pregnant women were enrolled for data collection in the EBF trial and followed-up to 7 days after birth. The PNMR, the SBR and the ENMR, were 79 per 1000 (95% CI: 59-99), 54 per 1000 (95% CI: 38-69) and 27 per 1000 (95% CI: 9-44), respectively. In a multivariable analysis, nulliparous women (RR = 2.90, 95% CI: 1.6-5.0), primiparae mothers (RR = 2.20, 95% CI: 1.2-3.9), twins (RR = 4.0, 95% CI: 2.3-6.9) and giving birth during the dry season (RR = 2.1 95% CI: 1.3-3.3) were factors associated with increased risk of perinatal death. There was no evidence that risk of perinatal death differed between deliveries at home and at a health centre
  
  
  CONCLUSIONS
  Our study observed the highest PNMR ever reported in Burkina. There is an urgent need for sustainable interventions to improve maternal and newborn health in the country.
authors: Centre MURAZ Research Institute, Ministry of Health/Burkina Faso, PO Box 390, Bobo-Dioulasso, Burkina Faso. hamadial@yahoo.fr
authors: Abdoulaye Hama
authors: AH
authors: Diallo
authors: Nicolas
authors: N
authors: Meda
authors: Emmanuel
authors: E
authors: Zabsonré
authors: Halvor
authors: H
authors: Sommerfelt
authors: Simon
authors: S
authors: Cousens
authors: Thorkild
authors: T
authors: Tylleskär
mesh_terms: D000328:Adult; D002050:Burkina Faso / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D054238:Perinatal Mortality; D011247:Pregnancy; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors