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

Figures & data

Figure 1. Flow chart of enrolment and follow-up of participants

Table 1. Characteristics of pregnant women in Lira, Uganda, by perinatal death and crude incidence risk ratio (IRR) and adjusted IRRs of perinatal death

	Total N = 1,877 n (%)	Perinatal death N = 81 n (%)	No perinatal death N = 1,796 n (%)	Crude incidence risk ratio (IRR) [95% CI]	Adjusted incidence risk ratio (IRR) [95% CI]
Maternal education
None	248 (13.2)	9 (11.1)	239 (13.3)	1	1
Primary	1,459 (77.7)	63 (77.8)	1,396 (77.7)	1.2 [0.5, 2.6]	1.1 [0.5, 2.4]
Secondary or higher	170 (9.1)	9 (11.1)	161 (9.0)	1.4 [0.6, 3.4]	1.0 [0.4, 2.9]
Maternal age
<20 years	510 (27.2)	32 (39.5)	478 (26.6)	2.1 [1.4, 3.1]	1.1 [0.5, 2.1]
20–30	988 (52.6)	30 (37.0)	958 (53.3)	1	1
>30 years	379 (20.2)	19 (23.5)	360 (20.0)	1.7 [1.0, 2.9]	2.5 [1.1, 5.8]
Marital status
Single	161 (8.7)	7 (8.6)	157 (8.7)	1	1
Married	1,713 (91.3)	74 (91.4)	1,639 (91.2)	1.0 [0.5, 1.9]	1.2 [0.6, 2.2]
Parity at enrolment
Nullipara	533 (28.4)	37 (45.7)	496 (27.6)	2.3 [1.6, 3.4]	2.7 [1.3, 5.6]
Between 1 and 4	954 (50.8)	29 (35.8)	925 (51.5)	1	1
5 and above	390 (20.8)	15 (18.5)	375 (20.9)	1.3 [0.7, 2.2]	0.6 [0.3, 1.3]
Wealth index
Lowest 40%	837 (44.6)	32 (39.5)	805 (44.8)	1	1
Middle 40%	665 (35.4)	31 (38.3)	634 (35.3)	1.2 [0.9, 1.8]	1.3 [0.9, 2.0]
Top 20%	375 (20.0)	18 (22.2)	357 (19.9)	1.2 [0.8, 1.9]	1.4 [0.8, 2.2]
Sub-county (place of residence)
Aromo	1,039 (55.4)	35 (43.2)	1,004 (55.9)	1	1
Agweng	838 (44.6)	46 (56.8)	792 (44.1)	1.6 [1.1, 2.5]	1.7 [1.1, 2.6]
ANC at enrolment
No	396 (21.1)	19 (23.5)	377 (21.0)	1.2 [0.8, 1.8]	1.3 [0.9, 2.0]
Yes	1,481 (78.9)	62 (76.5)	1,419 (79.0)	1	1
Maternal obesity
No	1,590 (84.7)	66 (81.5)	1,524 (84.9)	1	1
Yes	287 (15.3)	15 (18.5)	272 (15.1)	1.3 [0.7, 2.2]	1.2 [0.7, 2.2]
Parent trial allocation
Control	882 (47.0)	32 (39.5)	850 (47.3)	1	1
Intervention	995 (51.0)	49 (60.5)	946 (52.7)	1.4 [0.9, 2.1]	1.4 [0.9, 2.1]

Table 2. Probable cause of the 81 perinatal deaths among 1,877 women followed up from at least 28 weeks of gestation to 7 days postpartum in Lira, Northern Uganda, 2018–2019

			Place of birth
Type of perinatal death	Probable cause of death	Number (%)	Home	Health facility
Antepartum stillbirth	Congenital malformations, deformations and chromosomal abnormalities	4 (20.0)	2	2
	Infection	7 (35.0)	3	4
	Acute antepartum event	2 (10.0)		2
	Disorders related to length of gestation and fetal growth	4 (20.0)	3	1
	Antepartum death of unspecified cause	3 (15.0)	2	1
	Total antepartum	20	10	10
Intrapartum stillbirth	Trauma	1 (5.8)	1
	Acute intrapartum events	14 (82.4)	3	11
	Disorder related to fetal growth	2 (11.8)	1	1
	Total intrapartum	17	5	12
Early neonatal death	Congenital malformations, deformations and chromosomal abnormalities	3 (6.8)	1	2
	Disorders related to fetal growth	1 (2.3)	1
	Birth trauma	1 (2.3)	1
	Complications of intrapartum events (birth asphyxia)	16 (36.4)	5	11
	Infection	3 (6.8)		3
	Respiratory and cardiovascular disorders (respiratory failure)	16 (36.4)	3	13
	Low birth weight and prematurity	2 (4.5)	1	2
	Neonatal death of unspecified cause	2 (4.5)	1
	Total early neonatal	41	13	31