Maternal tetanus may follow delivery of a liveborn infant, a stillbirth, a miscarriage or an abortion.
Factors associated with obstetrical care and where it is given:
(1) delivery or preceding care outside of a medical facility
(2) delivery or care by attendants without medical or midwife training
(3) unclean hands
(4) unclean instruments
(5) environmental materials (dirt, straw, etc) on or about the care area
(6) animals kept nearby
(7) use of animal dung for fuel
(8) use of native remedies during and after the delivery
(9) use of native remedies for umbilical cord stump care
(10) exposure of the newborn infant to dirt, dung or other environmental materials
(11) performance of native surgical procedures
(12) no or inadequate vaccination of the mother against tetanus
(13) poverty
(14) poor education (and superstition?)
(15) poor prenatal care
(16) history of neonatal tetanus following a previous delivery
where:
• Neonatal tetanus is reported more often in male infants, but this could be due to a preferential bias in seeking care for a male offspring.
