PERINATOLOGY • Vol 24 • No. 1 • May–Aug 2023 • 55 Clinical Audit Kanchan S, et al. Perinatal Mortality Audit Conclusion: Improving perinatal outcome requires close monitoring of high-risk women and administering timely interventions. Timely referral to a tertiary care center with advanced life support for the neonate can help improve neonatal outcomes. Additionally, improving maternal and neonatal health care can be achieved by ensuring adequate antenatal care and intrauterine monitoring, providing nutritional supplementation, ensuring that the delivery is conducted by a professional, and promoting the concept of “a small family is a happy family”. Key Words: Perinatal mortality rate, antenatal care, early neonatal deaths, stillbirths, fetal growth restriction, congenital malformations, congenital infections, prematurity, low birth weight Introduction Perinatal mortality refers to fetal deaths at or after 28 weeks of gestation and neonatal deaths within the first 7 days of life. Perinatal mortality rate (PMR) is the ratio of perinatal mortality per 1000 live births. The perinatal period constitutes just 0.5% of an individual’s average lifespan, but the number of deaths that occur during this period is more than the deaths that occur over the next 30 to 40 years of life.1 The infant mortality rate has reduced to < 50 in India. Hence, PMR is now being considered as an important epidemiologic indicator of the country’s mother and child health care status.2 Inadequate care of the mother and neonate during this period can lead to deaths. A causal relationship is known to exist between PMR and a country’s socioeconomic development and environmental conditions. Hence, PMR is considered as a general indicator of socioeconomic well-being and general and public health conditions.3 PMR is one of the components in the standard-of-living assessment of a country. Perinatal mortality affects the improvement in the standard-of-living conditions of a country, and hence, reducing PMR is an important millennium development goal. Also, as perinatal mortality is a global issue, the worldwide reduction of PMR is of great importance. It is noteworthy that many countries have recorded a significant improvement in child mortality rate.4 Globally, there has been a 58% reduction in the annual under-5 mortality rate— the number of deaths has reduced from 12.5 million in 1990 to 5.2 million in 2019. In 1990, the under-5 mortality rate was 93.0 (91·7–94·5) per 1000 live births, while in 2019, it was 37.7 (36·1–40·8) per 1000 live births. Overall, the decade 1990 to 2019 has seen a 59% reduction in under-5 mortality, globally.5 Hence, this study was instituted to analyze the causative factors and trends associated with perinatal deaths, so that appropriate measures can be taken to improve the standard of health care in the hospital. Aim To analyze the causative factors and trends associated with perinatal deaths Materials and Methods Study design This was a retrospective study conducted at the Department of Obstetrics and Gynecology and Department of Neonatology of Kasturba Medical College (Manipal, Karnataka, India), a tertiary care center. Medical records pertaining to deliveries conducted between January 2019 and June 2020 were considered for this study. Institutional ethics committee approval was not sought for the study because this was part of the hospital’s regular audit cycle.
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