M. Chalumeau et al., Risk factors for perinatal mortality in West Africa: a population-based study of 20 326 pregnancies, ACT PAEDIAT, 89(9), 2000, pp. 1115-1121
The aim of the study was to identify simple clinical risk factors for perin
atal mortality (PNM) in different areas of West Africa, to quantify their p
revalence among pregnant women and to estimate their relative contribution
in the definition of high-risk status of PNM. The MOMA study was a prospect
ive population-based study in which data were collected on 20 326 pregnant
women in various, primarily urban, areas of Burkina Faso, Ivory Coast, Mall
, Mauritania, Niger and Senegal. The present report analyses 19 870 singlet
on births and 31 simple clinical variables with univariate and multivariate
methods. The mean PNM ratio was 42 per 1000 total births, and 62% of these
deaths were stillbirths. In the crude analysis, after adjustment or taking
prevalence into account, the principal risk factors were: vaginal bleeding
(immediately antenatal and intrapartum), hypertension (especially during l
abour), dynamic (prolonged labour and use of oxytocin) and mechanic (non-ce
phalic presentation) dystocia, and infection (prolonged rupture of the memb
ranes and intrapartum fever).
Conclusions: Most of the principal risk factors for PNM cannot be detected
during antenatal care visits but only in early labour. High-risk status sho
uld not be based solely on antenatal care visits, but should also take into
account monitoring during labour.