The burden of miscarriages and perinatal deaths in Sierra Leone, data
from a nation-wide household survey (PRESSCO 2020)
Abstract
Objective: This study identified the prevalence of miscarriages and
perinatal deaths from a community perspective. Design: A
population-based, cross-sectional household study. Setting: Sierra Leone
(West-Africa) from 2019-2020 Population: Women of reproductive age
Methods: Seventy-five randomized clusters were selected, 25 households
in each cluster and two random participants from each household. Female
participants between 12 and 50 years of age were interviewed about
family planning methods and obstetrical history. Main outcome measures:
miscarriage and perinatal death Results: A total of 914 women of
reproductive age were included. Family planning methods were used by
29% of the women. In total, 2,160 life-time pregnancies were recalled
of which 104 (5%, 95% CI 4-6%) resulted in an early pregnancy loss.
Eighty-three (80%) were reported as spontaneous abortion, 17% (18)
were intentional abortions, of which 9 were induced with medication
outside the hospital. The stillbirth rate was 18.5 (95% CI 9-31) per
1000 births and the perinatal mortality rate was 38,4 (95% CI 24-54)
per 1000 births calculated over a 5-year period. Conclusion: This study
confirms that the perinatal death rate in Sierra Leone exceeds the
global average. The miscarriages both spontaneous and intentional, are
likely to be underreported. Medical attention should be placed to treat
and investigate the causes of miscarriages and perinatal deaths.
Improving the use of family planning is needed to decrease the hidden
burden of intentional abortions. Funding: Norwegian University of
Science and Technology (NTNU) and University of Amsterdam’s Center of
Tropical Medicine and Travel Medicine.