Comparative study of perinatal mortality and morbidity in the community and at Medical College Hospital, Patna.

This study determines the perinatal mortality rate (PMR) among births recorded at the Women's Patna Medical College Hospital (PMCH) in India, and from other centers in the Patna district community, where the ICDS program was not implemented. Births include all infants over 28 weeks of gestational development and who weighed over 1000 g at birth. Infants were grouped by birth weights as follows: 1001-1500 g, 1501-2000 g, 2001-2500 g, 2501-3000 g, 3001-3500 g, and 3500 g. Newborns were observed for 1 week after birth, and mothers were encouraged to breast feed. Mothers of normal infants were discharged in 2-3 days and advised to attend the Well Baby Clinic in 1 week, or earlier in the case of illness. The perinatal mortality among 1000 infants included 29 stillbirths at PMCH and 39 stillbirths in the community, and 21 neonatal deaths at PMCH and 26 neonatal deaths in the community. The PMR was 50/1000 at PMCH and 65/1000 in the community. The PMR in blocks that had implemented ICDS was 35-41/1000. The lowest PMR was among infants weighing 2501-3000 g; the highest PMR was among infants weighing 1001-1500 g. The lower PMR at PMCH was attributed to better prenatal care. The leading causes of perinatal death in both groups were trauma and stress of labor. The most common illnesses were diarrhea (51.2% of cases) and conjunctivitis (51.5%). 24.4% of infants born in the community suffered from various diseases, including diarrhea (7.7%), hyperbilirubinemia (1.1%), and umbilical sepsis, respiratory distress, and hypoglycemia (0.5%). Both the Medical College Hospital and other community health centers must improve health services in order to meet the target of 30-35/1000 PMR by the year 2000.