Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study

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dc.contributor.authorArach, Anna Agnes Ojok
dc.contributor.authorTumwine, James K.
dc.contributor.authorNakasujja, Noeline
dc.contributor.authorNdeezi, Grace
dc.contributor.authorKiguli, Juliet
dc.contributor.authorMukunya, David
dc.contributor.authorOdongkara, Beatrice
dc.contributor.authorAchora, Vincentina
dc.contributor.authorTongun, Justin B.
dc.contributor.authorMusaba, Milton W.
dc.contributor.authorNapyo, Agnes
dc.contributor.authorTylleskar, Thorkild
dc.contributor.authorNankabirwa, Victoria
dc.date.accessioned2026-06-18T09:38:48Z
dc.date.available2026-06-18T09:38:48Z
dc.date.issued2020-12-02
dc.description.abstractBackground: Perinatal mortality in Uganda remains high at 38 deaths/1,000 births, an estimate greater than the every newborn action plan (ENAP) target of ≤24/1,000 births by 2030. To improve perinatal survival, there is a need to understand the persisting risk factors for death. Objective: We determined the incidence, risk factors, and causes of perinatal death in Lira district, Northern Uganda. Methods: This was a community-based prospective cohort study among pregnant women in Lira district, Northern Uganda. Female community volunteers identified pregnant women in each household who were recruited at ≥28 weeks of gestation and followed until 50 days postpartum. Information on perinatal survival was gathered from participants within 24 hours after childbirth and at 7 days postpartum. The cause of death was ascertained using verbal autopsies. We used generalized estimating equations of the Poisson family to determine the risk factors for perinatal death. Results: Of the 1,877 women enrolled, the majority were ≤30 years old (79.8%), married or cohabiting (91.3%), and had attained only a primary education (77.7%). There were 81 peri natal deaths among them, giving a perinatal mortality rate of 43/1,000 births [95% confidence interval (95% CI: 35, 53)], of these 37 were stillbirths (20 deaths/1,000 total births) and 44 were early neonatal deaths (23 deaths/1,000 live births). Birth asphyxia, respiratory failure, infec tions and intra-partum events were the major probable contributors to perinatal death. The risk factors for perinatal death were nulliparity at enrolment (adjusted IRR 2.7, [95% CI: 1.3, 5.6]) and maternal age >30 years (adjusted IRR 2.5, [95% CI: 1.1, 5.8]). Conclusion: The incidence of perinatal death in this region was higher than had previously been reported in Uganda. Risk factors for perinatal mortality were nulliparity and maternal age >30 years. Pregnant women in this region need improved access to care during preg nancy and childbirth.
dc.description.sponsorshipThis work was supported by the Survival Pluss project (no. UGA-13-0030) at Makerere University. Survival Pluss pro ject is financed by the Norwegian Programme for Capacity Development in Higher Education and Research for Development (NORHED) by the Norwegian Agency for Development Cooperation (NORAD), Norway.
dc.identifier.citationAnna Agnes Ojok Arach, James K. Tumwine, Noeline Nakasujja, Grace Ndeezi, Juliet Kiguli, David Mukunya, Beatrice Odongkara, Vincentina Achora, Justin B. Tongun, Milton W. Musaba, Agnes Napyo, Thorkild Tylleskar & Victoria Nankabirwa (2021) Perinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study, Global Health Action, 14:1, 1859823, DOI: 10.1080/16549716.2020.1859823
dc.identifier.otherhttps://doi.org/10.1080/16549716.2020.1859823
dc.identifier.urihttp://hdl.handle.net/20.500.14270/851
dc.language.isoen
dc.publisherTaylor & Francis
dc.subjectPerinatal death
dc.subjectperinatal mortality
dc.subjectearly neonatal deaths
dc.subjectrisk factors
dc.subjectUganda
dc.titlePerinatal death in Northern Uganda: incidence and risk factors in a community-based prospective cohort study
dc.typeArticle

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