Keywords
associated factors
reproductive health
birth planning
Kimpese
How to Cite
Abstract
Perinatal mortality remains a major public health problem, particularly in developing countries. In the Democratic Republic of the Congo, especially in the Kongo Central province, data on its specific determinants are still limited. This was a quantitative case-control study aimed at identifying factors associated with perinatal mortality at the IME General Referral Hospital (HGR IME) of Kimpese, conducted from January 1 to June 30, 2025. Maternal, ovular, and health system–related factors were analyzed in order to identify the determinants of perinatal mortality within this hospital. A total of 60 perinatal deaths were recorded out of 750 total births, corresponding to a rate of 80 per 1,000 births. Prematurity was the leading cause, accounting for 75% of cases, followed by neonatal asphyxia (8.3%), neonatal infections (6.6%), and other causes (10%). Most deaths occurred during the antepartum period (60%), followed by the early postnatal period (≤ 7 days after birth) with 25%, while 15% of deaths occurred during the intrapartum period. After multivariate regression analysis, several factors were independently associated with perinatal mortality. Low birth weight below 2500 g increased the risk of perinatal mortality nearly fivefold (ORa = 4.67; p = 0.001), as did a history of stillbirth (ORa = 4.00; p = 0.001). Obstetric complications such as placenta previa (ORa = 4.67; p = 0.001), retroplacental hematoma (ORa = 3.73; p = 0.001), postpartum hemorrhage (aOR = 4.31; p = 0.001), and preeclampsia (ORa = 4.28; p = 0.001) were also strongly associated with perinatal mortality. Cesarean section increased the risk by approximately 3.6 times (ORa = 3.63; p = 0.001). In addition, several health system–related factors significantly contributed to perinatal mortality, including lack of qualified staff (ORa = 3.50; p = 0.001), prolonged waiting time (ORa = 3.67; p = 0.001), geographical inaccessibility (ORa = 3.67; p = 0.001), and delays related to administrative procedures (ORa = 2.92; p = 0.007). A negative perception of the health system also increased the risk by about fourfold (ORa = 4.08; p = 0.001). Finally, belonging to the “Eglise de Noirs” religious group was associated with an almost threefold increase in the risk of perinatal mortality (ORa = 2.80; p = 0.024). In conclusion, perinatal mortality at the HGR IME of Kimpese is high and influenced by maternal, ovular, and health system–related factors. Reducing it requires an integrated approach combining improved quality of obstetric care, strengthening of human an
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