Does maternal behaviour influence the risk of perinatal death in Jamaica?

Features of behaviour of mothers of singleton perinatal deaths collected over the 12-month period from 1 September 1986 to 31 August 1987 were compared with 9919 mothers of singleton infants born in September and October 1986 and surviving the first week of life, as part of the Jamaican Perinatal Mortality Survey. For perinatal deaths as a whole, and in the presence of maternal age and social and environmental features, logistic regression analyses showed that the following were independently related with higher risk of mortality: (1) deliberately trying to get pregnant; (2) ever having used Depo Provera; (3) not drinking alcohol in pregnancy; and (4) smoking cigarettes in pregnancy. There were no associations with coital frequency, ever using the contraceptive pill or smoking ganja (cannabis). Deaths were classified using the Wigglesworth scheme, and separate analyses carried out for the three major groups--antepartum fetal deaths, deaths from immaturity and deaths from intrapartum asphyxia. Antepartum fetal deaths were at increased risk if (1) mothers were deliberately trying to get pregnant or (2) they had ever used Depo Provera. Deaths from immaturity were not associated with any health behaviour variables. Deaths from intrapartum asphyxia were more likely if (1) the mother was deliberately trying to get pregnant or (2) she had never used an intrauterine contraceptive device.