Machakos Project Studies: agents affecting health of mother and child in a rural area of Kenya. XVI. The outcome of pregnancy

Abstract

The outcome of pregnancy of all women belonging to the study population of the Machakos project studies who delivered during 1975 and 1976 is presented. The birth-rate was 43.0 per 1,000 population per year, the fertility rate was 235 per 1,000 women 15--44 years of age per year. Unexpected low mortality rates were found; stillbirths, neonatal and infant death rates were respectively 29.8 per 1,000 total births and 22.5 and 50.0 per 1,000 live births. One maternal death occurred among the 2,223 deliveries. Maternal age of less than 25 and over 34 years, a history of previous perinatal death and breech delivery were associated with higher perinatal mortality. Parity, marital status, birth-interval and maternal height were not associated with a difference in outcome of pregnancy. The stillbirth rate among the children born in hospital (26.4%) was 4.4% compared with 2.4% among the children born at home, neonatal and infant death rates were the same. Half of all perinatal deaths were caused by either prematurity or birth trauma, 75% of all infant deaths after the first week of life were caused by infections.

PIP: This paper describes the pregnancy outcome of women who delivered in 1975 and 1976 in the area of the Machakos project near Nairobi, Kenya. The study utilized a surveillance system comprising of home visits on 3700 households by 12 fieldworkers. Total number of children born during the study period was 2246. General fertility rate was 235/1000 women of reproductive age. Birth rate was 43.0/1000. There were unexpectedly low mortality rates. Stillbirths were 29.8/1000 total births, neonatal rate, 22.5/1000 total births while infant death rate was 50.0/1000 live births. There was 1 maternal death among the 2223 deliveries. Higher perinatal mortality was attributed to maternal age of less than 25 and over 34 years, a history of previous perinatal death, and breech delivery. Differences in outcome of pregnancy were not affected by parity, marital status, birth interval, and maternal height. Stillbirth rate of hospital-born children (26.4%) was 4.4% compared with 2.4% among children born at home. Half of all perinatal deaths were caused by either prematurity or birth trauma. Infections accounted for 75% of all infant deaths after the first week of life. A subsequent paper will relate the outcome of pregnancy to antenatal and delivery care received.