Objective: To measure the incidence of maternal and early neonatal mortality in women who gave birth at Moi
Teaching and Referral Hospital (MTRH) in Kenya and describe clinical and other characteristics and circumstances
associated with maternal and neonatal deaths following deliveries at MTRH.
Methods: A retrospective audit of maternal and neonatal records was conducted with detailed analysis of the most
recent 150 maternal deaths and 200 neonatal deaths. Maternal mortality ratios and early neonatal mortality rates
were calculated for each year from January 2004 to December 2011.
Results: Between 2004 and 2011, the overall maternal mortality ratio was 426 per 100,000 live births and the early
neonatal mortality rate (<7 days) was 68 per 1000 live births. The Hospital record audit showed that half (51%) of
the neonatal mortalities were for young mothers (15–24 years) and 64% of maternal deaths were in women
between 25 and 45 years. Most maternal and early neonatal deaths occurred in multiparous women, in referred
admissions, when the gestational age was under 37 weeks and in latent stage of labour. Indirect complications
accounted for the majority of deaths. Where there were direct obstetric complications associated with the delivery,
the leading cause of maternal death was eclampsia and the leading cause of early neonatal death was pre-mature
rupture of membranes. Pre-term birth and asphyxia were leading causes of early neonatal deaths. In both sets of
records the majority of deliveries were vaginal and performed by midwives.
Conclusion: This study provides important information about maternal and early neonatal mortality in Kenya’s
second largest tertiary hospital. A range of socio demographic, clinical and health system factors are identified as
possible contributors to Kenya’s poor progress towards reducing maternal and early neonatal mortality.