Perinatal mortality rate and associated risk factors in mogadishu, somalia: A hospital-based cross-sectional study.

INTRODUCTION

Perinatal mortality is a critical barometer of maternal and newborn health. In fragile states like Somalia, which grapple with prolonged conflict and systemic healthcare challenges, this indicator is particularly stark. Despite global progress, contemporary, localized data from this region remain scarce, hindering targeted public health initiatives. This study aimed to quantify the perinatal mortality rate (PMR) and identify key determinants within two major referral hospitals in Mogadishu.

METHODS

We conducted a hospital-based, cross-sectional study with a seven-day prospective follow-up from January to April 2020, including 352 mother-newborn dyads. Data on maternal demographics, antenatal care, delivery mode, and neonatal outcomes were collected via structured questionnaires and medical records. Multivariate logistic regression was used to identify independent predictors of perinatal mortality.

RESULTS

From 358 recorded deliveries, 62 perinatal deaths occurred, yielding an alarmingly high PMR of 173 per 1,000 total births. Stillbirths were the predominant component, accounting for 82% of these deaths. After multivariate adjustment, significant protective factors included maternal age of 22–29 years (Adjusted Odds Ratio [AOR]: 0.44; 95% CI: 0.21–0.94), primary or secondary education (AOR: 0.40; 95% CI: 0.16–0.95), and delivery via cesarean section (AOR: 0.33; 95% CI: 0.11–0.98). A history of previous stillbirth was a significant predictor in unadjusted but not in the final multivariate model.

CONCLUSION

This study reveals a severe, localized crisis of perinatal mortality in Mogadishu, driven overwhelmingly by stillbirths. The protective effects of maternal education and emergency obstetric care underscore the urgent need for systemic investments in maternal health services. Interventions must prioritize enhancing the quality of both antenatal and intrapartum care to avert these preventable tragedies.