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Reproductive Health
Published in: Reproductive Health 1/2013

Open Access 01-12-2013 | Research

A retrospective analysis of maternal and neonatal mortality at a teaching and referral hospital in Kenya

Authors: Faith Yego, Jennifer Stewart Williams, Julie Byles, Paul Nyongesa, Wilson Aruasa, Catherine D'Este

Published in: Reproductive Health | Issue 1/2013

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Abstract

Objective

To measure the incidence of maternal and early neonatal mortality in women who gave birth at Moi Teaching and Referral Hospital (MTRH) in Kenya and describe clinical and other characteristics and circumstances associated with maternal and neonatal deaths following deliveries at MTRH.

Methods

A retrospective audit of maternal and neonatal records was conducted with detailed analysis of the most recent 150 maternal deaths and 200 neonatal deaths. Maternal mortality ratios and early neonatal mortality rates were calculated for each year from January 2004 to December 2011.

Results

Between 2004 and 2011, the overall maternal mortality ratio was 426 per 100,000 live births and the early neonatal mortality rate (<7 days) was 68 per 1000 live births. The Hospital record audit showed that half (51%) of the neonatal mortalities were for young mothers (15–24 years) and 64% of maternal deaths were in women between 25 and 45 years. Most maternal and early neonatal deaths occurred in multiparous women, in referred admissions, when the gestational age was under 37 weeks and in latent stage of labour. Indirect complications accounted for the majority of deaths. Where there were direct obstetric complications associated with the delivery, the leading cause of maternal death was eclampsia and the leading cause of early neonatal death was pre-mature rupture of membranes. Pre-term birth and asphyxia were leading causes of early neonatal deaths. In both sets of records the majority of deliveries were vaginal and performed by midwives.

Conclusion

This study provides important information about maternal and early neonatal mortality in Kenya’s second largest tertiary hospital. A range of socio demographic, clinical and health system factors are identified as possible contributors to Kenya’s poor progress towards reducing maternal and early neonatal mortality.
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Literature
1.
Maternal mortality in 2000: Estimates developed by WHO, UNICEF, and UNFPA. 2000, Geneva: World Health Organization
2.
The Millennium Development Goals report 2011. 2011, New York: United Nations
3.
Building a Future for Women and Children: The 2012 Report. 2012, Geneva: World Health Organization
4.
Alvarez JL, Gil R, Hernández V, Gil A: Factors associated with maternal mortality in Sub-Saharan Africa: an ecological study. BMC Publ Health. 2009, 9 (462): 10-
5.
Callister LC: Global maternal mortality: contributing factors and strategies for change. MCN. 2005, 30 (3): 185-192.
6.
Population and Housing Census highlights. 2009, Nairobi: Kenya National Bureau of statistics
7.
Hogan MC, Foreman KJ, Naghavi M, Ahn SY, Wang M, Makela SM, Lopez AD, Lozano R, Murray CJL: Maternal mortality for 181 countries, 1980?2008: a systematic analysis of progress towards Millennium Development Goal 5. Lancet. 2010, 375 (9726): 1609-1623. 10.1016/S0140-6736(10)60518-1.CrossRefPubMed
8.
Oyieke JB, Obore S, Kigondu CS: Millenium development goal 5: a review of maternal mortality at the Kenyatta National Hospital, Nairobi. EAMJ. 2006, 83 (1): 4-9.
9.
Bauni E, Mochamah G, Ndila CMA, Kosgei P, Kapesa S, Nyutu G, TN W: Maternal mortality in a rural community of Coastal Kenya: insights from verbal autopsy (VA) in the Kilifi health and demographic surveillance system (KHDSS). 2013, Nairobi: The African Journal of Health Sciences
10.
Olopade F, Lawoyin T: Maternal mortality in a Nigerian maternity hospital. Afr J Biomed Res. 2008, 11: 267-273.
11.
Simiyu D: Morbidity and mortality of neonates admitted in general paediatric wards at Kenyatta National Hospital. East Afr Med J. 2003, 80 (12): 611-616.PubMed
12.
Lawn JE, Cousens S, Zupan J: 4 million neonatal deaths: When? Where? Why?. Lancet. 2005, 365: 891-900. 10.1016/S0140-6736(05)71048-5.CrossRefPubMed
13.
Lawn JE, Kerber K, Enweronu-Laryea C, Cousens S: 3.6 million neonatal deaths--what is progressing and what is not?. Semin Perinatol. 2010, 34 (6): 371-386. 10.1053/j.semperi.2010.09.011.CrossRefPubMed
14.
Tinker A, Ransom E: Save the Children. Healthy mothers and healthy newborns: the vital link In: Policy perspectives on newwborn health. 2002, Washington, DC USA: PRB
15.
Thompson A: Poor and pregnant in Africa: safe motherhood and human rights. Midwifery. 1999, 15 (3): 146-153. 10.1016/S0266-6138(99)90059-1.CrossRefPubMed
16.
Maine D: Too far to walk: maternal mortality in context. Social Sci Med. 1994, 38: 1091-1110. 10.1016/0277-9536(94)90226-7.CrossRef
17.
McCarthy J, Maine D: A framework for analyzing determinants of maternal mortality. Stud Fam Plann. 1992, 23 (1): 23-33. 10.2307/1966825.CrossRefPubMed
18.
Maine D, Akalin MZ, Ward VM, Kamara A: The design and evaluation of maternal mortality programs. 1997, NY: Center for population and Family Health Columbia University
19.
World Health Organization (WHO): Women and health: today’s evidence tomorrow’s agenda. Edited by: WHO. 2009, Geneva: WHO
20.
Filippi V, Ronsmans C, Campbell OM, Graham WJ, Mills A, Borghi J, Koblinsky M, Osrin D: Maternal health in poor countries: the broader context and a call for action. Lancet. 2006, 368: 1535-1541. 10.1016/S0140-6736(06)69384-7.CrossRefPubMed
21.
Reproductive Health Response in Conflict Consortium: Emergency obstetric care impact report. 2006, New York: RHRC
22.
Ukachukwu VE, Unger H, Onoka C, Nduka C, Maina S, Ngugi N: Maternal morbidity and mortality in peri-urban Kenya–assessing progress in improving maternal healthcare. East Afr J Public Health. 2009, 6 (2): 112-118.PubMed
23.
Rogo KO, Aloo-Obunga C, Ombaka C, Oguttu M, Orero S, Oyoo C, Odera J: Maternal mortality in Kenya: the state of health facilities in a rural district. East Afr Med J. 2001, 78 (9): 468-472.CrossRefPubMed
24.
Mwaniki MK, Gatakaa HW, Mturi FN, Chesaro CR, Chuma JM, Peshu NM, Mason L, Kager P, Marsh K, English M: An increase in the burden of neonatal admissions to a rural district hospital in Kenya over 19 years. BMC Publ Health. 2010, 10: 591-10.1186/1471-2458-10-591.CrossRef
25.
Magadi M, Diamond I, Nyovani M: Analysis of factors associated with maternal mortality in Kenyan Hospitals. Biosoc Sci. 2001, 33 (3): 375-389. 10.1017/S0021932001003753.CrossRef
26.
Juma EA, Odiyo FN: Maternal mortality occurring at the Rift Valley Provincial General Hospital, Nakuru. East Afr Med J. 2000, 77 (7): 382-385.PubMed
27.
World Health Organization: ICD-10: International statistical classification of diseases and related health problems (10th Rev. ed.). 2008, New York, NY: Author
28.
Neonatal and Perinatal Mortality: Country, Regional and Global Estimates 2006. 2006, Geneva: World Health Organization
29.
30.
Oestergaard MZ, Inoue M, Yoshida S, Mahanani WR, Gore FM, Cousens S, Lawn JE, Mathers CD, on behalf of the United Nations Inter-agency Group for Child Mortality E, the Child Health Epidemiology Reference G: Neonatal Mortality Levels for 193 Countries in 2009 with Trends since 1990: A Systematic Analysis of Progress, Projections, and Priorities. PLoS Med. 2011, 8 (8): e1001080-10.1371/journal.pmed.1001080.CrossRefPubMedPubMedCentral
31.
Trends in maternal mortality: 1990 to 2008: estimates developed by WHO, UNICEF, UNFPA and World Bank. 2010, Geneva: World Health Organization
32.
Mosha T, Philemon N: Factors influencing pregnancy outcomes in Morogoro Municipality, Tanzania. Tanzan J Health Res. 2010, 12 (4): 249-260.PubMed
33.
Bacak SJ, Baptiste-Roberts K, Amon E, Ireland B, Leet T: Risk factors for neonatal mortality among extremely-low-birth-weight infants. Am J Obstet Gynecol. 2005, 192 (3): 862-867. 10.1016/j.ajog.2004.07.029.CrossRefPubMed
34.
Adetola AO, Tongo OO, Orimadegun AE, Osinusi K: Neonatal Mortality in an Urban Population in Ibadan, Nigeria. Pediatr Neonatol. 2011, 52 (5): 243-250. 10.1016/j.pedneo.2011.06.001.CrossRefPubMed
35.
Sayem A, Nury A, Hossain MB: Achieving the Millenium Developement Goal for under-five mortality in Bangladesh: Current status and lessons for issues and challenges for further improvements. Health Popul Nutr. 2011, 2: 92-102.
36.
Ness A, Goldberg J, Berghella V: Abnormalities of the First and Second Stages of Labor. Obstet Gynecol Clin N Am. 2005, 32 (2): 201-220. 10.1016/j.ogc.2005.01.007.CrossRef
37.
Kale P, Costa A: Maternal deaths in the city of Rio de Janeiro, Brazil, 200–2003. Health Popul Nutr. 2009, 6: 794-801.
38.
Ujah L, Aisien O, Mutihir JT, Vanderjagt R, Glew R, Uguru V: Factors contributing to maternal mortaltiy in North-Central Nigeria: a seventeen-year review. Afr J Reprod Health. 2005, 9 (3): 27-40. 10.2307/3583409.CrossRefPubMed
Metadata
Title
A retrospective analysis of maternal and neonatal mortality at a teaching and referral hospital in Kenya
Authors
Faith Yego
Jennifer Stewart Williams
Julie Byles
Paul Nyongesa
Wilson Aruasa
Catherine D'Este
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2013
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/1742-4755-10-13

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