Objectives: To determine the spatial patterns of perinatal mortality in Kocaeli, Turkey using
geographic information systems (GIS); to examine whether regional differences exist for
the period selected; and whether these differences are linked to regional risk factors.
Study design: Ecological research.
Methods: Data were obtained from the linked birthedeath records data registry maintained
by Kocaeli Provincial Health Directorate. Mortality data are added to the geodatabase on
a monthly basis. Spatial patterns of mortality rates were determined with GIS by mapping
the case differences in the districts, and spatial autocorrelation was used to examine the
spatial pattern of mortality rates in the region.
Results: Various risk factors contributing to spatial variation of perinatal mortality were
revealed in the region. Districts with high mortality rates were shown to be sensitive to
these risk factors. The results of this study confirm the direct link between perinatal
mortality and poor environmental conditions in the study region. The analyses applied in
the study showed that some complex demographic and socio-economic factors should be
associated with perinatal mortality rates to identify the geographic patterns of mortality.
Conclusions: Implementation of spatial tools within GIS for mortality data showed the
efficiency of GIS in perinatal mortality surveillance. This study also demonstrated the
capability and utility of GIS to clarify the geographical distribution of perinatal mortality