| Summary: | 碩士 === 國立陽明大學 === 公共衛生研究所 === 96 === Background: Perinatal mortality rate is a population health indicator for planning and evaluating health programs. It is a sensitive index of child health, maternal and perinatal care. Perinatal mortality remains a challenge worldwide, but particularly for developing countries. In Belize it continues to be a public health problem thus, there is a need to understand the basic epidemiology and associated factors to perinatal mortality so as to address appropriate perinatal health.
Objectives: This study analyzes the trends in perinatal mortality over a six year period – 2001 to 2006 in Belize. In addition, it assesses factors associated with perinatal mortality among public hospital deliveries in one year period- January 1 to December 31, 2006.
Methods: A retrospective observational study was conducted to analyze the trends of perinatal mortality for a six year period using hospital monthly aggregate maternity report. Furthermore, due to data limitation we then used data from public hospitals maternity registers to assess possible risk factors associated with perinatal mortality for a one year period, 2006. For analysis of the data, the SPSS statistical package version 15 was used to describe the trends and to estimate the risk of perinatal death for each potential risk factor.
Results: The perinatal mortality rate has been increasing over the years and is at a high of 16.36 per 1000 total births for 2006. There is also large regional variation of the trends of perinatal mortality rate over the six year period of the study. The Southern region consistently had a significantly higher perinatal rate than the other regions (Northern, Central, and Western). After adjusting for all other factors, risk factors for perinatal mortality were maternal age of >35 years (OR 2.638); birth weight of 1500-2499 grams (OR 4.773) and <1500 grams (OR 20.681); complications during labor (OR 3.532); and regions.
Conclusion: The southern region maintains a higher perinatal mortality rate over the other three regions. Possible reasons for this high rate could be due to poor socioeconomic status, cultural ethnicity towards health care, and lack of medical resources; therefore future efforts have to focus on the Southern region. Women who were thirty-five years and older, babies who weighted <2500 grams and women who had complications during labor were significantly associated with perinatal deaths. Optimal management of care should target these high risk groups. This could be done through preconception counseling, frequent prenatal visits, skilled attendance during childbirth and refocused postpartum care for mother and the baby. More research on the specific causes of these perinatal deaths would assist in planning appropriate interventions.
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