title: Prospective audit of perinatal mortality among inborn babies in a tertiary health center in Lagos, Nigeria.
abstract: BACKGROUND
  The perinatal mortality rate remains an important indicator of maternal care and maternal health and nutrition, and also reflects the quality of obstetric and pediatric care available. The causes of most of the perinatal deaths are preventable, thus making it important to identify the risk factors in each health environment.
  
  
  OBJECTIVE
  The aim was to prospectively audit the perinatal mortality and associated risk factors in a tertiary health facility in a developing country.
  
  
  METHODS
  Data for all consecutive deliveries in the labor ward complex of Lagos University Teaching Hospital (LUTH) between June 2002 and November 2002 were obtained from the patients' record and by interviewing the mothers using a questionnaire. The babies were followed up for 7 days post delivery.
  
  
  RESULTS
  There were 51 (8.5%) perinatal deaths made up of 43 (7.1%) stillbirths (15 fresh and 28 macerated) and 8 (6.1%) early neonatal deaths giving a perinatal mortality rate of 84.6/1000. Maternal factors that significantly affected perinatal deaths were maternal age, parity, antenatal care booking and the hospital where the mother was booked for antenatal care, number of previous child deaths, and complications of pregnancy. Mode of delivery and complications of labor were the significant intrapartum factors. Fetal factors that influenced perinatal deaths were fetal presentation, birth weight, and Apgar scores at 1 and 5 min. When multiple logistic regression (multivariable analysis) of perinatal mortality on possible risk factors was done, only the Apgar score at 5 min, birth weight, and parity were significant risk factors.
  
  
  CONCLUSIONS
  The study shows a high perinatal mortality rate with majority of perinatal deaths occurring before the delivery. Significant risk factors are a low Apgar score at 5 min, low birth weight, and high parity.
authors.affiliation: Department of Paediatrics, Lagos University Teaching Hospital, Lagos, Nigeria. ekaekure@yahoo.com
authors.forename: E N
authors.initials: EN
authors.lastname: Ekure
authors.forename: V C
authors.initials: VC
authors.lastname: Ezeaka
authors.forename: E
authors.initials: E
authors.lastname: Iroha
authors.forename: Mtc
authors.initials: M
authors.lastname: Egri-Okwaji
mesh_terms: D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008423:Maternal Age; D008485:Medical Audit; D009549:Nigeria / Q000453:epidemiology; D054238:Perinatal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology*; D011295:Prenatal Care; D011446:Prospective Studies; D011787:Quality of Health Care; D012307:Risk Factors; D012959:Socioeconomic Factors; D050497:Stillbirth / Q000453:epidemiology; D055815:Young Adult