Perinatal outcomes in Agincourt: 1995-2000
Date
2014
Authors
Duworko, James Tanu
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Objective: The objective is to estimate the magnitude and determinants of perinatal mortality in
Agincourt, and determine whether there is a difference in perinatal mortality rate between South
Africans and self-settled Mozambicans.
Design: Case-control study of 134 cases and 136 controls using longitudinal data drawn from the
Agincourt dataset for the period 1995-2000
Methods: All cases were matched against a random selection of 136 controls. Odds ratios were used
to assess risk, with p-values for trend where necessary. Logistic regression was used to determine
independent effects of significant risk factors.
Limitations of the study: Probable under-reporting of stillbirths and early neonatal deaths.
Results: The Agincourt perinatal mortality rate is estimated as 13.4 per 1000 births (95%CI, 11.23-
15.8) with an increasing trend from 1995-2000 (X2 for trend 19.487, p-value <0.001). Delivery by a
nurse attendant is a protective factor but not independently so. Multivariate analysis indicates that
babies of women who never attended antenatal clinic during the index pregnancy are at higher risk of
perinatal death (OR= 7.55; 95%CI, 2.03-28.05) compared to others whose mothers attended antenatal
clinic at least four times. Women with history of perinatal death are at a higher risk of experiencing it
again, compared with those without (OR =13.68; 95%CI, 1.43-130.82). The difference in perinatal
mortality rate for South Africans (13.3) and former Mozambican refugees (11.8) is not statistically
significant (p-value = 0.522).
Conclusion: Perinatal mortality is rising; key risk factors are non-attendance for antenatal care by
mothers, and previous perinatal death. There is no significant difference in perinatal mortality rate
between South Africans and self-settled Mozambicans in Agincourt.
Description
A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand in partial fulfillment of the requirements for the degree of Master of Science
in Medicine (Epidemiology and Biostatistics)
Johannesburg, May 2014