title: Determinants of perinatal mortality in Marondera district, Mashonaland East Province of Zimbabwe, 2009: a case control study.
abstract: BACKGROUND
  Marondera District recorded perinatal mortality ratios of 58.6/1000 and 64.6/1000 live births in 2007 and 2008 respectively. These ratios were above provincial averages of 32/1000 and 36/1000 during the same periods. We determined factors associated with perinatal mortality in Marondera District.
  
  
  METHODS
  A 1:2 unmatched case control study was carried out from June to August 2009. A case was any mother in Marondera District who had a stillbirth or early neonatal death from 01/08/2008 to 31/07/2009. A control was any mother whose baby survived the perinatal period during the same period. We calculated Odds Ratios and their 95% confidence intervals.
  
  
  RESULTS
  We interviewed 103 cases and 206 controls. Primary or no maternal education [OR=5.50 (3.14-9.33)] labor complications [OR=7.56 (4.38-13.06)], home delivery [OR=7.38 (4.03-13.68)] and preterm delivery [OR=15.06 (8.24-27.54)] increased the risk for perinatal mortality. Antenatal care booking [OR=0.19 (0.10-0.34)], having a gainfully employed husband [OR=0.36 (0.20-0.63)] and living within 5 km of a health facility [OR=0.41 (0.22-0.78)] reduced the risk. Independent determinants of perinatal mortality included being apostolic [AOR=3.11 (1.05-9.18)], having a home delivery [AOR 7.17 (2.48-20.73)], experiencing labor complications [AOR=8.99 (3.11-25.98)], maternal HIV infection [AOR=5.36 (2.02-14.26)], antenatal care booking [AOR=0.32 (0.18-0.87)] and birth weight below 2500 g [AOR=9.46 (3.91-27.65)].
  
  
  CONCLUSIONS
  Labor complications, belonging to apostolic sect, having a home delivery, maternal HIV infection, low birth weight and antenatal care booking were independently associated with perinatal mortality. Health worker training in emergency management of obstetric and neonatal care was initiated. Marondera District started holding perinatal mortality meetings.
authors: University of Zimbabwe, Department of Community Medicine PO Box A178 Avondale Harare, Zimbabwe.
authors: Emmanuel
authors: E
authors: Tachiweyika
authors: Notion
authors: N
authors: Gombe
authors: Gerald
authors: G
authors: Shambira
authors: Addmore
authors: A
authors: Chadambuka
authors: Tshimamga
authors: T
authors: Mufuta
authors: Simukai
authors: S
authors: Zizhou
mesh_terms: D016022:Case-Control Studies; D036861:Delivery, Obstetric / Q000379:methods / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D006700:Home Childbirth / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D054238:Perinatal Mortality; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology*; D015030:Zimbabwe / Q000453:epidemiology