Perinatal mortality in urban slums in Lucknow.

Abstract

To determine the perinatal mortality rate (PNMR) in the urban slums of LucknowCross-sectional survey.Twenty five Anganwadi centres of urban Lucknow, with a population of 25,901.Data was collected on birth and early neonatal deaths, gestational age of the neonate (determined at birth) and maternal variables like socio-economic status, maternal age, parity, and bad obstetrical history from January 1992 to March 1993.There were 966 births with a still-birth rate of 37.2 and PNMR of 59.0 per 1000. The relative risk of perinatal mortality with lower socio-economic status was 1.87, bad obstetrical history 2.18, and gestational age < 37 weeks 1.95.Further reduction in PNMR may be possible with focussed medical services to women of low socio-economic status having bad obstetrical history and those delivering before term.This study examines the nature and extent of perinatal mortality in the urban slums of Lucknow, India. A survey was conducted during 1992-93 among all mothers who had a birth during the study period and were registered in one of 25 Anganwadi centers. Causes of death were determined by verbal autopsy (neonatal jaundice, birth injury, infections, and asphyxia). The study area population numbered 25,901. There were 966 deliveries, of which 930 were live births. There were 36 stillbirths, 21 early neonatal deaths, and 57 perinatal deaths. 99 live born infants were premature births. The stillbirth rate was 37.2/1000 live births. The perinatal mortality rate (PNMR) was 59.0/1000. This rate was lower than findings among slum women in Delhi and Jabalpur. PNMR was higher among older women and higher parities, women of low socioeconomic status, women with a poor obstetric history, women with inadequate prenatal care, and premature infants or those delivered by untrained persons. The highest relative risk of PNMR was associated with a poor obstetric history, followed by prematurity, low socioeconomic status, and no prenatal care. The leading cause of death was asphyxia (42.1%), followed by prematurity (14.03%) and infections (12.3%). Over 50% of deliveries were performed by untrained persons, and 80% were home deliveries, despite the availability of medical facilities. Attainment of the national goal of reducing PNMR to under 30/1000 will be dependent upon registration of pregnant mothers, detection of high-risk cases and timely intervention, delivery by trained medical persons, and limitation of family size.