Perinatal morbidity refers to the condition in which an infant or mother suffers from complications arising from pregnancy until the first twenty-eight days after birth.

Perinatal mortality includes stillbirths, neonatal deaths, and deaths from other cause within the first twenty-eight days of birth. According to the World Health Organization (WHO), the global perinatal mortality rate is 18 deaths per 1000 births, with developing countries having higher rates than developed countries.

A high perinatal morbidity rate can be caused by a combination of factors, and this article will discuss the leading causes.

Maternal Age

Maternal age plays a significant role in perinatal morbidity rates.

A maternal age of less than twenty years old is associated with an increased risk of perinatal mortality, and the likelihood of complications during pregnancy and birth is higher for women in this age group. Similarly, women aged over 40 years are also at a higher risk of perinatal morbidity and mortality.

The reason behind this increased risk at either end of the age scale is possibly due to the higher rate of adverse health habits and conditions in these women compared to those in the prime reproductive age group.

Preterm Births

Preterm births occur before 37 weeks of pregnancy, resulting in a decreased chance of the baby surviving and proper fetal development.

Premature infants are at higher risk of health issues such as neonatal respiratory distress, intraventricular hemorrhage, and necrotizing enterocolitis. Factors such as multiple pregnancies, maternal conditions such as hypertension or diabetes, and previous preterm birth can lead to preterm labor.

Bacterial Infection

Bacterial infections such as Group B Streptococcus and Chorioamnionitis can cause severe complications for both the mother and baby, leading to perinatal morbidity and mortality.

Group B Streptococcus disease is the most common cause of early-onset neonatal infection, and it can cause pneumonia, sepsis, and meningitis. Chorioamnionitis, on the other hand, is an inflammation of fetal membranes and can cause preterm delivery, fetal distress, and postnatal infections.

Inadequate Prenatal Care

Inadequate prenatal care is a significant contributor to perinatal morbidity rates. Women who do not receive prenatal care or receive inadequate care are at higher risk of complications during pregnancy or labor.

Women who receive prenatal care are more likely to receive early diagnoses of fetal or maternal issues, which can promote early intervention and positive outcomes.

Birth Defects

Birth defects are prevalent issues that can cause perinatal morbidity and mortality. Some birth defects are preventable through the use of folic acid supplements and immunizations against certain diseases.

Early screening and diagnosis of structural abnormalities through genetic testing or other diagnostic measures can help identify and manage potential risks before birth.

Low Birthweight

Low birth weight babies, those weighing less than 5 pounds 8 ounces at birth, have an increased risk of perinatal morbidity and mortality.

Infants with low birth weight are at higher risk of complications such as respiratory distress syndrome, sepsis, and perinatal asphyxia. Factors such as maternal smoking during pregnancy, multiple gestations, or placental insufficiency can cause low birth weight.

Multiparity

Women who have given birth multiple times are at increased risk of perinatal morbidity compared to first-time mothers. The risk of complications, such as preterm labor, increases with each subsequent pregnancy.

Multiparity is also associated with an increased risk of placental complications such as placenta previa and placental abruption.

Gestational Diabetes

Gestational diabetes occurs in pregnant women who have previously been diagnosed with diabetes during pregnancy. Gestational diabetes can cause perinatal morbidity due to fetal macrosomia, neonatal hypoglycemia, and respiratory distress syndrome.

Gestational diabetes can be managed through diet and exercise changes or medical interventions.

Hypertensive Disorders

Hypertensive disorders such as preeclampsia or gestational hypertension can cause maternal and fetal complications. These disorders can cause adverse outcomes such as premature delivery, fetal growth restriction, and maternal organ damage.

Management of hypertensive disorders in pregnancy involves close monitoring of the mother and fetus, medications, and prompt delivery when necessary.

Conclusion

A high perinatal morbidity rate is a cause for concern and can be caused by several factors. It is essential to identify and manage these factors to improve perinatal outcomes.

Proper prenatal care, early diagnosis and intervention, and lifestyle changes can help prevent or manage complications during pregnancy and childbirth.