Incidence and causes of perinatal mortality in Hyderabad, Andhra Pradesh, India.

The incidence extent and causes of perinatal mortality were studied in 26230 viable births in Hyderabad; there were 1747 perinatal deaths (79.8/1000) 900 of which were clinically studied in detail. Overall incidence of premature births was 29%. Perinatal mortality rates were high with low and high birthweight infants twins low and high maternal age (under 19 or over 40 years) primaparity and grand multiparity and male fetuses. Causes of perinatal mortality included: 1) trauma and stress of labor (31-41%) 2) toxemia of pregnancy (16%) 3) antepartum hemorrhage (6.6%) 4) maternal diseases (13-16%) and 5) congenital deformity (8-12%). Pathological findings on 400 autopsies included 1) morbid anatomical changes due to anoxia 2) pulmonary lesions 3) birth trauma 4) congenital defects 5) syphilis 6) infections and 7) erythroblastosis fetalis. A large majority of mothers appeared to be mal- and undernourished. Perinatal mortality was lowest in the 7.6-8.5-pound birthweight infants and in spontaneous cephalic deliveries. It is concluded that perinatal mortality is largely preventable and that the majority of perinatal deaths results from prematurity and stress of labor; biological causes are those related to maternal age and parity.