A prospective survey of the outcome of pregnancy in a rural area of the Gambia.

The outcome of pregnancy was studied in 672 women over a 1-year period in a rural area of the Gambia where medical resources were very limited, prior to the introduction of a primary health care programme. Maternal mortality was very high (22 per 1000), mainly caused by postpartum haemorrhage and infections. Stillbirth and neonatal death rates were also high (35 and 65 per 1000, respectively); prematurity and infections were the main causes of death in neonates. First or late pregnancies, ages under 20 or over 40 years, and multiple pregnancies were all associated with a poor outcome of pregnancy. Women in these groups should therefore be encouraged by traditional birth attendants and by the staff of rural antenatal clinics to deliver in a health centre or hospital.