Perinatal Mortality Rate Selected in Bangkok Hospitals and Provincial Medical Schools in Thailand : 1991

Abstract

Objective To ascertain the accurate perinatal death rate, epidemiological informations and causes of perinatal death from the reliable vital statistic hospital-based data during a one year period.

Subjects and methods During January - December 1991 study forms were sent to all those participated hospitals and an obstetrician or neonatal intensive care unit personnel collected all informations and returned completed forms to the principal investigator monthly.

Results There were 99,309 births during one year, 684 stillbirths and 421 early neonatal deaths. Crude perinatal mortality rate was 11.26 per 1,000 total births. When excluding lethal congenital malformations crude perinatal mortality rate was 9.7 per 1,000 total births. For the regional studies, the group of hospitals in Bangkok, Khonkaen, and Songkla have crude perinatal mortality rate per 1,000 total births of 10.3, 18.8, 9.6 and 7.5 respectively. Seventy-nine percent of fetal deaths occurred among mother age group of 20-34 years old, low education, low income, no ANC (22.2%) and insufficient ANC (26.5% ANC less than 4 times). For causes of fetal death, 6.2/1,000 births were maceration, 1.7/1,000 births were asphyxia, 1.5 /1,000 births were premature and unknown 0.8 /1,000 births. Causes of fetal deaths were proved by autopsy in 48.7%. 

Conclusion From this study, the problems of mother and child care are a reflection of the whole problems in economy, social and the national education. The government should improve the level of national education, increase the national income and institute better social welfare. Campaign of antenatal care programme, proper identification and referral of high risk cases, counselling programmes for premarital couples, prenatal diagnosis and also encourage family planning during post-natal care are all essential. In addition, the inter-departmental conferences among obstetricians, paediatricians, nurses and medical related personnels should be set up to analyse and correct the problems. With all of these integrated settings, the crude perinatal mortality rate could be reduced.