Prevalence and Factors Associated with Perinatal Deaths at Igunga District Hospital in Tabora, Tanzania

Abstract

Yusto Biswamo, Stella Mushy, Hamza Lilenga and Aziza S. Machenje

Background: Perinatal mortality remains a significant public health challenge, particularly in low- and middle-income countries. Globally, the stillbirth rate is estimated at 13.9 per 1,000 births, contributing to approximately 2.6 million stillbirths annually. South Asia records the highest rates (40–70 per 1,000 births), while Sub-Saharan Africa has an estimated stillbirth rate of 21.7 per 1,000 births. In Tanzania, the perinatal mortality rate is approximately 38 per 1,000 pregnancies. Despite various government interventions, the rates remain unacceptably high, particularly in Tabora region and Igunga District, where limited research has been conducted to identify specific determinants. Understanding the prevalence and contributing factors is essential for designing targeted interventions.

Objective: To investigate the prevalence and factors associated with perinatal death at Igunga district hospital in Tabora region, Tanzania.

Methodology: A retrospective cross-sectional study employed, a convenience sampling method, utilizing all available files with complete information on perinatal deaths to identify specific causes of perinatal death at Igunga Hospital. All files of perinatal deaths between 2024 to 2020 were reviewed, and only 365 files that met the inclusion criteria were analyzed. Data were collected using structured data abstraction tools and analyzed using SPSS v21 and Stata v17. Descriptive statistics summarized socio-demographic and obstetric characteristics. Bivariate analyses were performed using chi- square and Fisher’s exact tests, and modified Poisson regression was used to identify factors independently associated with perinatal deaths.

Results: The average age of participants was 26.7 years (SD ±7.3 years), with the majority of women falling within the 20–35-year age range (64.7%). The prevalence of perinatal deaths was 15.8%. The highest stillbirth rate was recorded in 2021 (15.2 per 1,000 deliveries), and the lowest in 2020 (10.9 per 1,000). Increased risk was associated with maternal age 36–45 years (aPR: 1.08; p = 0.027), secondary education (aPR: 1.29; p = 0.003), rural residence (aPR: 1.19; p < 0.001), and gestation of more than 40 weeks (aPR: 1.15; p < 0.001). Protective factors included a high socio-economic status (aPR: 0.53; p < 0.001) and attending at least 3 antenatal care visits (aPR: 0.82; p = 0.004).

Conclusion: Perinatal mortality remains high in Igunga District, with birth asphyxia, prematurity, and neonatal sepsis being the leading causes. Maternal, fetal, and healthcare-related factors, including inadequate antenatal care, intrapartum complications, delayed decision-making, and rural residence, were key contributors. Strengthening maternal and newborn health services, ensuring timely risk identification, and addressing health system and socioeconomic gaps are essential for reducing preventable perinatal deaths in similar rural settings.

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