The current pattern of facility-based perinatal and neonatal mortality in Sagamu, Nigeria

Background: Perinatal and neonatal mortality rates have been described as sensitive indices of the quality of health care services. Regular audits of perinatal and neonatal mortalities are desirable to evaluate the various global interventions. Objective: To describe the current pattern of perinatal and neonatal mortality in a Nigerian tertiary health facility. Methods: Using a prospective audit method, the socio-demographic parameters of all perinatal and neonatal deaths recorded in a Nigerian tertiary facility between February 2017 and January 2018 were studied. Results: There were 1,019 deliveries with stillbirth rate of 27.5/1000 total births and early neonatal death (END) rate among in-born babies of 27.2/1000 live births. The overall perinatal mortality rate for in-facility deliveries was 53.9/1000 total births and neonatal mortality (till the end of 28 days) rate of 27.2/1000 live births. Severe perinatal asphyxia and prematurity were the leading causes of neonatal deaths while obstructed labour and intra-partum eclampsia were the two leading maternal conditions related to stillbirths (25.0% and 21.4% respectively). Gestational age < 32 weeks, age < 24 hours and inborn status were significantly associated with END (p = 0.002, p <0.001 and p = 0.002 respectively). Conclusion: The in-facility perinatal mortality rate was high though stillbirth rate was relatively low. There is a need to improve the quality of emergency obstetric and neonatal services prior to referral to tertiary facilities.