Background:

Perinatal mortality is a major public health problem, particularly in developing countries  where three quarters of neonatal deaths happen in the first week of life. Therefore, it is crucial to understand factors associated with perinatal mortality in order to design strategies and interventions that will improve newborn outcomes.

Methods:A prospective cohort study was carried out, whereby pregnant women with gestational age ≥ 28 weeks were enrolled. Interviews were conducted during antenatal booking using structured questionnaire. Follow-up visits were made within 48 hours after delivery and on seventh day postdelivery.Results:A total of 959 pregnant women wereenrolled; 38 were lost to follow-up prior delivery. The remaining 921 partici-pants, resulting in PMR of 45.5 per 1000 births. Over half of the deaths werestillbirths (SBR 29.6 per 1000 births) and early neonatal deaths (ENMR 16.8per 1000 live births). Using Generalized Linear Model (GLM), risk factorsassociated with perinatal mortality included: maternal age ≥ 35 years (ARR3.0, 95% CI: 1.0 to 9.0), nulliparous women (ARR 4.2, 95% CI: 1.6 to 11.1),assisted vaginal delivery (ARR 5.1, 95% CI: 1.4 to 19.0), home delivery (ARR3.3, 95% CI: 1.6 to 6.6), previous newborn death (ARR 4.0, 95% CI: 1.5 to10.1), pregnancy-induced hypertension (ARR 4.8, 95% CI: 2.4 to 9.4), herbaluse during labour (ARR 2.4, 95% CI: 1.2 to 5.1) and newborn asphyxia (ARR 5.9, 95% CI: 1.3 to 26.5).

Conclusions:

Perinatal mortality was found to be high in Zanzibar. Healthcare providers should pay special attention to womenwith pregnancy-induced hypertension and nulliparous women throughout