Perinatal mortality in rural Burkina Faso: a prospective community-based cohort study.
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.
Diallo
Abdoulaye Hama
AH
Centre MURAZ Research Institute, Ministry of Health/Burkina Faso, PO Box 390, Bobo-Dioulasso, Burkina Faso. hamadial@yahoo.fr
Meda
Nicolas
N
Zabsonré
Emmanuel
E
Sommerfelt
Halvor
H
Cousens
Simon
S
Tylleskär
Thorkild
T
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