A retrospective analysis of maternal and neonatal mortality at a teaching and referral hospital in Kenya

Reproductive Health

Catherine D'Este¹  Wilson Aruasa²  Paul Nyongesa³  Julie Byles⁴  Jennifer Stewart Williams⁴  Faith Yego⁵ 

[1] Centre for Clinical Epidemiology and Biostatistics, HMRI Building, University of Newcastle, University Drive, 2308, Callaghan, NSW, Australia;Clinical Services, Moi Teaching and Referral Hospital, Nandi Road, 30100, Eldoret, Kenya;Reproductive Health Department, Moi University, Nandi Road, 30100, Eldoret, Kenya, Australia;Research Centre for Gender, Health and Ageing, HMRI Building, University of Newcastle, University Drive, 2308, Callaghan, NSW, Australia;Department of Health Policy and Management, Moi University, Nandi Road, Eldoret 30100, Kenya

关键词: Early neonatal mortality rate;    Maternal mortality ratio;    Kenya;    Referral hospital;    Determinants;    Early neonatal mortality;    Maternal mortality;   

Others  :  811759
DOI  :  10.1186/1742-4755-10-13

 received in 2012-07-31, accepted in 2013-02-14,  发布年份 2013

【 摘 要 】

Objective

To measure the incidence of maternal and early neonatal mortality in women who gave birth at Moi Teaching and Referral Hospital (MTRH) in Kenya and describe clinical and other characteristics and circumstances associated with maternal and neonatal deaths following deliveries at MTRH.

Methods

A retrospective audit of maternal and neonatal records was conducted with detailed analysis of the most recent 150 maternal deaths and 200 neonatal deaths. Maternal mortality ratios and early neonatal mortality rates were calculated for each year from January 2004 to December 2011.

Results

Between 2004 and 2011, the overall maternal mortality ratio was 426 per 100,000 live births and the early neonatal mortality rate (<7 days) was 68 per 1000 live births. The Hospital record audit showed that half (51%) of the neonatal mortalities were for young mothers (15–24 years) and 64% of maternal deaths were in women between 25 and 45 years. Most maternal and early neonatal deaths occurred in multiparous women, in referred admissions, when the gestational age was under 37 weeks and in latent stage of labour. Indirect complications accounted for the majority of deaths. Where there were direct obstetric complications associated with the delivery, the leading cause of maternal death was eclampsia and the leading cause of early neonatal death was pre-mature rupture of membranes. Pre-term birth and asphyxia were leading causes of early neonatal deaths. In both sets of records the majority of deliveries were vaginal and performed by midwives.

Conclusion

This study provides important information about maternal and early neonatal mortality in Kenya’s second largest tertiary hospital. A range of socio demographic, clinical and health system factors are identified as possible contributors to Kenya’s poor progress towards reducing maternal and early neonatal mortality.

【 授权许可】

   
2013 Yego et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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