MATERNAL AND PERINATAL-MORTALITY FIGURES IN 249 SOUTH-AFRICAN HOSPITALS - 1988-1992

Objective. To determine maternal and perinatal mortality ratios in a l arge number of South African hospitals and assess the differences in m ortality figures among the main ethnic groups, Design. Questionnaire s urvey involving confidential reports on maternal and perinatal deaths submitted over the 5-year period 1988 - 1992. Setting. South Africa an d Namibia. Participants. A total of 249 hospitals in the southern Afri can region provided regular monthly mortality statistics, The statisti cs were presented both as an absolute number of deliveries and as the ethnic distribution of maternal and perinatal mortality. Outcome measu res. For the purpose of analysis, four ethnic groups (whites, blacks, coloureds and Asians) were assessed, Total births, maternal and perina tal death ratios were determined. Results. The 249 hospitals that took part in this survey represent 30% of all the hospitals in South Afric a, There were 570 938 deliveries, Blacks, whites, coloureds and Asians accounted for 77%, 12%, 8% and 3% respectively, Stillbirths numbered 16 874 (3%) and 8 384 (1.5%) neonatal deaths were reported, Perinatal mortality rates (PMRs) among the four ethnic groups were: blacks 52,5/ 1 000 deliveries, coloureds 36.7, Asians 14.4 and whites 8.0, The aver age PMR was 44.7/1 000 deliveries. During the 5-year period, 420 mater nal deaths representing a maternal mortality ratio (MMR) of 76 deaths/ 100 000 live births were reported (blacks 84/100 000, coloureds 113/10 0 000, whites 13/100 000 and Asians 12/100 000), There was no obvious annual trend within the 5-year period for either PMR or MMR, However, a comparison of MMR for this review period with two earlier reports (1 970 - 1979 and 1980 - 1982) shows a drop in MMR from 125/100 000 to 76 /100 000 live births. Conclusions. The MMRs and PMRs found by us, thou gh not representative of South Africa as a whole, are encouraging, bei ng among the lowest ratios reported by similar studies across Africa, Substantial differences were found in both MMRs and PMRs among the pri ncipal ethnic groups in South Africa, and we attribute them to the dis parity in socio-economic levels.