Sociodemographic characteristics and perinatal mortality among singletons in North East Tanzania: a registry-based study

Objectives: Sub-Saharan Africa has the highest known perinatal mortality rates in the World, but few studies have assessed the importance of parental sociodemographic characteristics on perinatal mortality in this region. The aim of this study was to estimate how sociodemographic patterns affect perinatal mortality in Northern Tanzania. Design and settings: A registry-based study using births from 1999 to 2006 at a hospital in North Eastern Tanzania. Participants and methods: 14 394 singleton births with birthweight 500 g or higher and a known perinatal survival status. Births of women with residence outside the local district who were referred to the hospital for delivery for medical reasons were excluded. Results: Perinatal mortality was 41.1 per 1000 births. Factors independently associated with higher perinatal mortality were: higher paternal age (. 45) compared to age 26-35 (adjusted relative risk (ARR) 2.0; 95% CI 1.4 to 2.8), low paternal education ( only primary) compared to secondary or higher ( ARR 1.3; 95% CI 1.1 to 1.7), paternal ethnicity other than Chagga or Pare ( ARR 1.4; 95% CI 1.1 to 1.7), paternal farming occupation ( ARR 1.5; 95% CI 1.1 to 2.2), maternal service occupation ( ARR 1.7; 95% CI 1.2 to 2.6), maternal height 150 cm or lower ( ARR 1.4; 95% CI 1.0 to 1.8) and residence in the rural or semi- urban area ( ARR 1.4; 95% CI 1.1 to 1.7). Conclusions: There are strong sociodemographic gradients in perinatal mortality in Africa. Paternal social characteristics appear to have stronger influence on perinatal mortality than maternal characteristics. This may reflect social and cultural conditions that need to be considered by policymakers in developing countries.