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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2016

Open Access 01-12-2016 | Research article

Better than nothing? maternal, newborn, and child health services and perinatal mortality, Lubumbashi, democratic republic of the Congo: a cohort study

Authors: Abel Mukengeshayi Ntambue, Françoise Kaj Malonga, Michele Dramaix-Wilmet, Roger Nlandu Ngatu, Philippe Donnen

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

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Abstract

Background

The Democratic Republic of Congo (DRC) has a high rate of perinatal mortality (PMR), and health measures that could reduce this high rate of mortality are not accessible to all women. Where they are in place, their quality is not optimal. This study was initiated to assess the relationship between these suboptimal maternal, newborn and child health (MNCH) services and perinatal mortality (PM) in Lubumbashi, DRC’s second-largest city.

Methods

We conducted a prospective cohort study, comparing women who had no, low, moderate, or high numbers of antenatal care (ANC) visits; three different levels of delivery care; and who did or did not attend postnatal care (PNC). Women were followed for 50 days after delivery, with PM as the primary endpoint.

Results

Uptake of recommended prenatal interventions was between 11-43 % among ANC attenders, regardless of the frequency of their visits. PM was 26 per 1000. ANC attendance was associated with PM. Newborns of mothers who had the lowest attendance had a mortality two times higher than newborns of women who had not attended ANC (low visits: adjusted odds ratio (aOR) = 2.2; 95 % confidence interval (CI) = 1.4-3.8). However, moderate (aOR = 1.4; 95 % CI =0.7–2.2) and high (aOR = 1.3; 95 % CI 0.7–2.2) attendance were not statistically significantly associated with PM. PNC attendance was not significantly associated with lower PM (relative risk 0.4, 95 % CI 0.1–2.6). Emergency obstetric and newborn care (EmONC) was significantly associated with a reduction in mortality (aOR = 0.2; 95 % CI = 0.2–0.8), with an 84.4 % reduction among newborns at risk, and an overall reduction in mortality of 10 % for all births.

Conclusion

Perinatal mortality was high among the infants of women in the cohort under study (26 per 1000 live births). Availability of MNCH, specifically EmONC, was associated with lower perinatal mortality, and if this association is causal, might avert 84.4 % of perinatal deaths among newborns at high-risk.
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Metadata
Title
Better than nothing? maternal, newborn, and child health services and perinatal mortality, Lubumbashi, democratic republic of the Congo: a cohort study
Authors
Abel Mukengeshayi Ntambue
Françoise Kaj Malonga
Michele Dramaix-Wilmet
Roger Nlandu Ngatu
Philippe Donnen
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-0879-y

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