Perinatal mortality 1982-2001 at Vila Central Hospital, Vanuatu

Objective: To determine the perinatal mortality at Vila Central Hospital (VCH) and thereby make an estimate of Vanuatu's perinatal mortality. Methods: Labour floor and nursery records from VCH, Vanuatu's only tertiary referral hospital, were examined and collated for the period 1982-2001. Death certificate books were also examined. The perinatal mortality rate was calculated as the sum of stillbirths (infants = 20 weeks and/or = 500 g) and neonatal mortality (deaths <28 days). Premature infants were recorded for infants less than 37 weeks gestation and small-for-gestational-age for infants less than 2500 g. Results: The mean perinatal mortality rate for the period was 27/1000, (range 15-36/1000). The mean stillbirth rate was 15/1000, (range 8-22/1000). The neonatal mortality was 12/1000, (range 4-18/1000). Premature babies accounted for 37/1000 births, (range 11-80/1000). Small-for-gestational-age infants were recorded in 45/1000 births, (range 16-83/1000). The mean twinning rate was 12/1000. Seven spontaneous triplets, two quadruplets and two pairs of siamese twins were born. Sepsis, meconium aspiration and birth asphyxia were the commonest causes of neonatal death. Conclusion: Accurate data collection is difficult in Vanuatu. There is the risk of under-ascertainment however, the figure of 27/1000 represents the current best possible estimate of perinatal mortality at VCH over the last 20 years. VCH is Vanuatu's premier hospital and it is likely that the national figure for perinatal mortality is higher, probably in the range of 37-39/1000. This places Vanuatu's perinatal mortality at a level 30 years or more behind Australia. These figures represent the largest account of hospital based perinatal data collected from any Pacific island nation.