ArticleBMJ open2020
Prospective study to explore changes in quality of care and perinatal outcomes after implementation of perinatal death audit in Uganda.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 6 citations in OpenAlex.
- Oxygen blenders for prevention of retinopathy of prematurity are highly cost-effective in Uganda.Frontiers in medicine · 2026Article
- Clinical profiles, incidence and predictors of early neonatal mortality at Mbarara Regional Referral Hospital, south-western Uganda.BMC pediatrics · 2024Article
- Facility-based stillbirth review processes used in different countries across the world: a systematic review.EClinicalMedicine · 2023Article
- Article
- "Death audit is a fight" - provider perspectives on the ethics of the Maternal and Perinatal Death Surveillance and Response (MPDSR) system in Ethiopia.BMC health services research · 2022Article
- Walk the Talk: The Transforming Journey of Facility-Based Death Review Committee from Stillbirths to Neonates.BioMed research international · 2021Article
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the effects of perinatal death (PND) audit on perinatal outcomes in a tertiary hospital in Kampala.
designInterrupted time series (ITS) analysis.
settingNsambya Hospital, Uganda.
participantsLive births and stillbirths.
interventionsPND audit. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes: perinatal mortality rate, stillbirth rate, early neonatal mortality rate. SECONDARY OUTCOMES: case fatality rates (CFR) for asphyxia, complications of prematurity and neonatal sepsis.
results526 PNDs were audited: 142 (27.0%) fresh stillbirths, 125 (23.8%) macerated stillbirths and 259 (49.2%) early neonatal deaths. The ITS analysis showed a decrease in perinatal death (PND) rates without the introduction of PND audits (incidence risk ratio (IRR) (95% CI) for time=0.94, p<0.001), but an increase in PND (IRR (95% CI)=1.17 (1.0 to -1.34), p=0.0021) following the intervention. However, when overdispersion was included in the model, there were no statistically significant differences in PND with or without the intervention (p=0.06 and p=0.44, respectively). Stillbirth rates exhibited a similar pattern. By contrast, early neonatal death rates showed an overall upward trend without the intervention (IRR (95% CI)=1.09 (1.01 to 1.17), p=0.01), but a decrease following the introduction of the PND audits (IRR (95% CI)=0.35 (0.22 to 0.56), p<0.001), when overdispersion was included. The CFR for prematurity showed a downward trend over time (IRR (95% CI)=0.94 (0.88 to 0.99), p=0.04) but not for the intervention. With regards CFRs for intrapartum-related hypoxia or infection, no statistically significant effect was detected for either time or the intervention.
conclusionThe introduction of PND audit showed no statistically significant effect on perinatal mortality or stillbirth rate, but a significant decrease in early neonatal mortality rate. No effect was detected on CFRs for prematurity, intrapartum-related hypoxia or infections. These findings should encourage more research to assess the effectiveness of PND reviews on perinatal deaths in general, but also on stillbirths and neonatal deaths in particular, in low-resource settings.
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