Perinatal Mortality and Its Associated Risk Factors: A Study in the North-East of Iran

Document Type : Original Article


1 Traditional and Complementary Medicine Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.

2 Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran.

3 MD, Student Research Committee, Sabzevar University of Medical Sciences, Sabzevar, Iran.


Background: Perinatal mortality rate is an important indicator of community health status. This study aimed to evaluate perinatal mortality and its determinants in Mobini Hospital of Sabzevar, Iran.
Methods: This descriptive, cross-sectional study was performed within a two-year (2011-2012) period at Mobini Hospital of Sabzevar. Our study population included all the cases of stillbirth and live birth after the 22nd week of gestation to full term, died within the first week after delivery. The data including maternal and neonatal/fetal age, parity, mode of delivery, history of stillbirth, gestational age, reason of death, gender, and weight of the fetus or newborn were obtained from patient records as well as interviews with the mothers and treating physicians. To analyze the data, independent sample t-test, and Chi T square/Fisher’s exact test were run using SPSS, version 11.5.
Results:Perinatal mortality and stillbirth rates were 16.6 and 9.1 per 1000 births, respectively, while the rate of early neonatal mortality was 7.4 per 1000 live births. The most common reasons for neonatal death were pre-term labor and sepsis, while the most common reason for stillbirth was unknown etiology. There was a significant difference between stillbirth and early neonatal death in term of gestational age (P<0.001).
Conclusion: According to our results, perinatal mortality rate in our region was not high compared to other regions of the country, although it was higher than that of European countries. We found that premature labor was the cardinal cause of neonatal mortality, which can be prevented by careful perinatal care and improving hospital equipment, especially those of neonatal intensive care units.


  1. Kiasari AZ, Kabirzadeh A, Saravi BM, Rezazadeh E, Khademlou M, Biazar T. Rate and causes of perinatal mortality in Imam Hospital, Sari 2007. Iran J Obstet Gynecol Infertil. 2009; 12(2):23-30.
  2. Cunningham FG, Leveno KJ, Bloom SL, Hauth J, Gilstrap L, Wenstrom K. Williams obstetrics. 23nd ed. NewYork: McGRAW Hill Medical Publishing Division; 2010. P. 235-41.
  3. Skordis N, Toumba M, Savva SC, Erakleous E, Topouzi M, Vogazianos M, et al. High prevalence of congenital hypothyroidism in the Greek Cypriot population: results of the neonatal screening program 1990-2000. J Pediatr Endocrinol Metab. 2005; 18(5):453-62.
  4. Falahzadeh H, Golestan M, Amin R, Zafar MA, Hakimi K, Ahmadabadi M, et al. The prevalence of and related factors in neonatal mortality in Yazd. Singapore Med J. 2011; 52(10):730-3.
  5. Forssas E, Gissler M, Hermminki E. Declining perinatal mortality in Finland between 1987 and 1994: contribution of different subgroups. Eur J Obstet Gynecol Reprod Biol. 1998; 80(2):177-81.
  6. Jokhio AH, Winter HR, Cheng KK. An intervention involving traditional birth attendants and perinatal and maternal mortality in Pakistan. N Engl J Med. 2005; 352(20):2091-9.
  7. Hadavi MA, Alidalaki S, Aminzadeh F. Effective factors on perinatal mortality in Rafsanjan Hospitals (2004-2006). J Rafsanjan Univ Med. 2009; 8(2):117-26.
  8. Esmail Nasab N, Majidzadeh SR, Nadim A. An epidemiologic study of neonatal mortality and fetal death and risk factors in Kordestan. Hakim Res J. 2001; 4(4):272-7 (Persian).
  9. Kiasari AZ, Kabirzadeh A, Saravi BM, Rezazadeh E, Khademlou M, Biazar T. Rate and causes of perinatal mortality in Imam Hospital, Sari 2007. Iran J Obstet Gynecol Infertil. 2009; 12(2):23-30.

10. Schmiegelow C, Minja D, Oesterholt M, Pehrson C, Suhrs HE, Boström S, et al. Factors associated with and causes of perinatal mortality in northeastern Tanzania. Acta Obstet Gynecol Scand. 2012; 91(9):1061-8.

11. Cruz-Antonho V, Talavera JO, Vazquez L, Antonio A, Castellanos A, Lezana MA, et al. The importance of quality of care in perinatal mortality: a case control study in Chiapas, Mexico. Arch Med Res. 2004; 35(6):554-62.

12. Adam I, Jumaa AM, Elbashir HM, Karsany MS. Maternal and perinatal outcomes of dengue in PortSudan, Eastern Sudan. Virol J. 2010; 7:153.

13. Ecevit A, Oguz SS, Tarcan A, Yazici C, Dilmen U. The changing pattern of perinatal mortality and causes of death in central Anatolian region of Turkey. J Matern Fetal Neonatal Med. 2012; 25(9):1738-41.

14. Kidanto HL, Mogren I, van Roosmalen J, Thomas AN, Massawe SN, Nystrom L, et al. Introduction of a qualitative perinatal audit at Muhimbili National Hospital, Dar es Salaam, Tanzania. BMC Pregnancy Childbirth. 2009; 9(1):45.

15. Burke L, Suswardany DL, Michener K, Mazurki S, Adair T, Elmiyati C, et al. Utility of local health registers in measuring perinatal mortality: a case study in rural Indonesia. BMC Pregnancy Childbirth. 2011; 11(1):20.

16. Andargie G, Berhane Y, Worku A, Kebede Y. Predictors of perinatal mortality in rural population of Northwest Ethiopia: a prospective longitudinal study. BMC Public Health. 2013; 13(1):168.

17. Tracy SK, Dahlen H, Caplice S, Laws P, Wang YA, Tracy MB, et al. Birth centers in Australia: a national population-based study of perinatal mortality associated with giving birth in a birth center. Birth. 2007; 34(3):194-201.

18. Pasupathy D, Wood AM, Pell JP, Fleming M, Smith GC. Rates of and factors associated with delivery-related perinatal death among term infants in Scotland. JAMA. 2009; 302(6):660-8.

19. Treurniet HF, Looman CW, van der Maas PJ, Mackenbach JP. Regional trend variations in infant mortality due to perinatal conditions in the Netherlands. Eur J Obstet Gynecol Reprod Biol. 2000; 91(1):43-9.

20. Allanson ER, Muller M, Pattinson RC. Causes of perinatal mortality and associated maternal complications in a South African province: challenges in predicting poor outcomes. BMC Pregnancy Childbirth. 2015; 15(1):37.

21. Hematyar M, Yarjou S. Causes of perinatal mortality at Javaheri hospital during a 7-year period 1996-2003. Med Sci J Islamic Azad Univ Tehran Med Branch. 2005; 1(15):37-40 (Persian).

22. Sharifzadeh GR, Rajaeifard A, Namakin K. An epidemiological study on neonatal mortality and its determinants in rural areas of Birjand. J Birjand Univ Med Sci. 2003; 10(3):25-30 (Persian).

23. Fonseca SC, Coutinho Eda S. Perinatal mortality research in Brazil: review of methodology and results. Cad Saude Publica. 2004; 20(Suppl 1):S7-19.

24. Bayou G, Berhan Y. Perinatal mortality and associated risk factors: a case control study. Ethiop J Health Sci. 2012; 22(3):153-62.

25. Khatamidoust F, Vakilian K, Fatahi BG. Study of perinatal mortality risk factors in Taleghani hospital (ARAK-IRAN). J Med Coun I R I. 2010; 28(1):56-61 (Persian).