PERINATOLOGY • Vol 24 • No. 1 • May–Aug 2023 • 59 Clinical Audit Kanchan S, et al. Perinatal Mortality Audit Maternal hypertensive diseases had a significant effect on the SBR (52.47%). Diabetes contributed to 14.85% of early neonatal deaths. Intrauterine growth restriction (IUGR) was the significant cause of stillbirths (66.67% including both macerated and fresh stillbirths). Table 3. Causes of Perinatal Mortality Perinatal Mortality Cause Macerated Fresh Total (%) IUGR Very early 5 2 20 (66.67)a Early 2 3 Late preterm 3 IUGR with Doppler changes 5 Severe Oligohydramnios 1 1 2 Twins 1 0 1 Anomalies 1 1 2 Intrauterine Hypoxia 2 2 6 Eclampsia 0 1 Intrapartum Stress 0 1 FMH 0 0 0 Abruption 0 2 2 Unexplained 3 1 4 Total (%) 23 (62.2) 14 (37.8) (100) Early Neonatal Mortality Cause Number Total (%) Prematurity Extreme 10 19 (45.31)a Early 9 Late 10 Anomalies 7 7 (10.93) Preterm FGR 7 7 (10.93) PPROM 3 3 (4.68)b Sepsis Early onset 7 13 (20.31) Late onset 6 Hypoxic–Ischemic Encephalopathy Birth asphyxia 1 5 (7.81) Intrauterine hypoxia-abruption 4 Total 64 (100) 64 (100) Maternal Risk Factors and Their Association With Perinatal Mortality Maternal Risk Factor Number Total (%) Diabetes GDM controlled 5 15 (14.85) GDM with FGR 3 Overt DM 3 GDM uncontrolled 4 Hypertensive Disorders of Pregnancy Early-onset preeclampsia 17 53 (52.47)a Preeclampsia 11 Recurrent preeclampsia 7 Severe preeclampsia 9 Eclampsia 3 APLA/SLE 3 Chronic Hypertension 3 Twins 4 4 (3.9) Heart Failure 3 3 (2.97) Multiple Pregnancies 10 8 (7.9) Bad Obstetric History Recurrent pregnancy loss 6 10 (9.9) Recurrent abruption 1 Recurrent IUD 1 Recurrent anomalies 2 aIUGR, prematurity, and maternal hypertensive disorders contributed the highest to PMR. bPPROM contributed the lowest to PMR. APLA, antiphospholipid antibodies; DM, diabetes mellitus; FGR, fetal growth restriction; FMH, fetomaternal hemorrhage; GDM, gestational diabetes mellitus; IUD, intrauterine death; IUGR, intrauterine growth restriction; PPROM, preterm premature rupture of membranes; SLE, systemic lupus erythematosus. Discussion PMR is an index that reflects on the quality of both antenatal and postnatal care. Hence, it is an essential parameter for the assessment of the health care status of a country. The global infant mortality rate has seen a gradual but remarkable reduction from 45.1 in 2011 to 28.23 in 2019. There is a paucity of PMR data of all countries. Hence, a comparison of the SBR and neonatal mortality rate (NMR) is considered a feasible alternative. In 2019, the SBR was 13.93 in India, which is less
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