title: Risk factors for perinatal deaths in Pakistan.
abstract: OBJECTIVE
  The aim of this study was to identify the risk factors for perinatal deaths in Pakistan, where perinatal mortality is still very high.
  
  
  METHODS
  This prospective cohort study was conducted in Sindh Government Lyari General Hospital, Karachi from 1 May 2006 to 30 April 2008. During this period, all perinatal deaths and each live infant delivered following every perinatal death (which were taken as controls) were enrolled. Demographic information, birthweight, booking status, associated obstetric risk factors, stillbirth or neonatal death and the cause of death were recorded. Univariate logistic regression was used to determine the effect of categorized weight, booking status, sex and the obstetric risk factors on perinatal death.
  
  
  RESULTS
  A total of 1103 deliveries were conducted during this period with 119 perinatal deaths. Stillbirths constituted 68.9% while there were early neonatal deaths in 31.1% cases. Booking status, gestational age, weight of fetus and the presence of obstetric risk factors were found to have significant (P-value < 0.05) association with perinatal deaths. Among the obstetric risk factors, abruptio placentae was the commonest (13.4%) and the commonest cause of death was identified as birth asphyxia (44.5%). There was a strong association between birthweight and perinatal death.
  
  
  CONCLUSIONS
  The high perinatal death rate in this study is comparable to other hospital-based studies and indicates the poor health status, inadequate prenatal and intranatal care and lack of services in our setup. In order to achieve the Millennium Development Goals-4, much work is needed to improve the quality of care, to identify high-risk cases and to carry out their proper management.
authors.affiliation: Dow University of Health Sciences, Karachi, Pakistan. perveen89rzw@yahoo.com
authors.forename: Fouzia
authors.initials: F
authors.lastname: Perveen
authors.forename: Subhana
authors.initials: S
authors.lastname: Tayyab
authors.forename: Bader Faiyaz
authors.initials: BF
authors.lastname: Zuberi
mesh_terms: D001724:Birth Weight; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D010154:Pakistan; D054238:Perinatal Mortality; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D050497:Stillbirth; D015996:Survival Rate