Perinatal mortality

Perinatal mortality comprises neonatal deaths and still-births. It overlaps somewhat with foetal death. The perinatal mortality in an area is very much an indication of the quality of the maternal and child health services in general, and of the quality of antenatal and maternity care in particular. The causes of perinatal mortality are those of the component problems.

There are 130 official ways for an infant to die. These are listed in the International Classification of Diseases sanctioned by WHO. After 1979, vaccines were no longer one of the accepted causes of infant death and the coroner would be forced to choose another cause of death. SIDS would be a likely alternative choice.

Perinatal mortality ratios (PMRs) reported by individual countries for 1965 varied from 18.3 to 82.0 per 1000 live births. In developing countries, where 72% of the world's population live, the risk of death in the perinatal period is between 40 and 80 per 1000, a figure several times higher than that of developed countries. Sample surveys suggest that even higher PMRs may occur. The influence of poor diet, disease, and impoverished social environment may result in a higher mortality rate after the first week and especially between 1 and 4 years; thus, for 1000 live births, 300 children might die before the age of 5 years. On the other hand, a number of countries, mostly highly developed, reported PMRs of under 25, less than half those recorded 30 years ago. Nonetheless, in developed countries perinatal mortality is a more important problem than is mortality after the first week of life. Some European countries have mortality rates of less than 10 per 1000 live births for the period one week to one year of age. One of the targets of the 1974 World Population Plan of Action specified that "countries with the highest mortality levels should aim by 1985 to have an infant mortality rate of less than 120 per 1000 live births. Although infant mortality rates have dropped in virtually all regions of the developing world, this goal has not been met by the countries with the highest infant mortality levels. The gap between the average level of infant mortality between developed and developing countries is very wide – 17 infant deaths per 1000 live births in developed countries compared with 92 per 100O in the developing world.

A 1993 World Bank report showed 4 million stillbirths or late foetal deaths every year in developing countries.