Risk factors for stillbirth and early neonatal death: a case-control study in tertiary hospitals in Addis Ababa, Ethiopia (original) (raw)
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Perinatal mortality and associated risk factors: a case control study
Ethiopian journal of health sciences, 2012
Perinatal mortality is reported to be five times higher in developing than in developed nations. Little is known about the commonly associated risk factors for perinatal mortality in Southern Nations National Regional State of Ethiopia. A case control study for perinatal mortality was conducted in University hospital between 2008 and 2010. Cases were stillbirths and early neonatal deaths. Controls were those live newborns till discharged from the hospital. Subgroup binary logistic regression analyses were done to identify associated risk factors for perinatal mortality, stillbirths and early neonatal deaths. A total of 1356 newborns (452 cases and 904 controls) were included in this analysis. The adjusted perinatal mortality rate was 85/1000 total delivery. Stillbirths accounted for 87% of total perinatal mortality. The proportion of hospital perinatal deaths was 26%. Obstructed labor was responsible for more than one third of perinatal deaths. Adjusted odds ratios revealed that obs...
Primary Health Care Open Access
Background: Birth is a critical time for the mother and fetus. In Ethiopia rates of new born morbidity and mortality are among the highest in the world. Even though many African mothers including Ethiopian mothers' pregnancies are ending up in perinatal mortality, little was investigated to identify the associated factors. Methodology: A facility based retrospective cross-sectional study was conducted in July, 2015 in Wolaita Sodo University teaching and referral Hospital by collecting data through record review of all women who gave birth at the hospital within the past one year preceding the survey. Systematic sampling technique was used to select 300 subjects. Epi-data version 1.4.4.0 and SPSS version 20 were used to enter and analyze data respectively. Proportions and means were used to describe the study population by explanatory variables whereas; Bivariate and multivariable logistic regression were used to identify the candidate and predictor variables respectively. All statistical tests were considered significant at alpha <0.05. Result: Among the 300 mothers who delivered their index child at Wolaita Sodo University teaching and referral hospital, 52(17.3%) of them had a dead perinatal outcome. Antenatal care visit, obstructed labor, referral from other health facility, cord prolapse, preeclampsia and birth weight were identified as predictors of perinatal outcome. Conclusion: Perinatal death in Wolaita Sodo referral hospital is tremendously high, which seeks a due attention. Hence, to avert the situation, improvement in antenatal care service (supported with ultrasound examination); improving obstetrics care; and early diagnosis and appropriate management of severely asphyxiated fetus at the time of delivery could reduce the prevalence. Easily accessible health facilities (which provide comprehensive essential and emergency obstetric services) could reduce perinatal death attributable to referral related causes. Besides, to have a safe delivery, health facilities should give due attention to the use of partograph.
African Health Sciences, 2019
Background: Stillbirth is a death before the complete expulsion or extraction from the mother. The burden is severe and high in developing countries. Risk factors for stillbirth are not yet studied in Ethiopia. Objective: To identify risk factors of stillbirth among mothers delivered in public hospitals of Central Zone Tigray, Ethiopia Methods: A case-control study design was used. Data collection period was from January to April 2018. Study subjects 63 cases and 252 controls were selected using systematic random sampling technique from respective hospitals. The interviewer-administered questionnaire, observational, and chart analysis were used to collect the data. A binary logistic regression model was employed. Results were presented at significance level P-value <0.05.
The Open Public Health Journal
Introduction: Fetal death is one of the common adverse pregnancy outcomes. More than 7178 deaths at 28 weeks of gestation occur every day, making 2.6 million fetal deaths worldwide. The majority of these deaths occurred in developing countries, and 98% occurred in low and middle-income countries. To address the problem of stillbirth, the magnitude and determinants of stillbirth must be understood to help intervention be given to reduce fetal stillbirth. This study was facilitated by obtaining basic data on the factors influencing stillbirth. This will facilitate the development of better public health interventions to reduce these preventable fetal deaths and improve maternal health. Objective: This study aimed to assess the determinant factors of still-birth among babies born in hospitals in the North Shoa zone, Oromia, Ethiopia. Methods: The study was conducted among 348 babies born in the hospital of North Shoa Zone. Study subjects were selected by systematic sampling method from...
Pediatric Health, Medicine and Therapeutics
Background: Perinatal asphyxia determines the newborn's future health status and viability with risk factors yet to be completely understood. It measures the status of the healthcare delivery of an organization including antenatal, intranatal, and postnatal care. In Ethiopia, 31.6% of neonatal mortality was attributed to perinatal asphyxia. This study aimed to assess the risk factors of perinatal asphyxia. Methods: An unmatched case-control study was conducted on 213 (71 cases selected using lottery method and 142 controls systematically) subjects in Addis Ababa from November 1, 2018 to June 30, 2019. Data were collected using a structured questionnaire through face-toface interviews, entered to Epi data version 4.4, and exported to SPSS version 25 for analysis. Logistic regression was used for analysis. Variables with p< 0.25 in bivariate analysis were taken to multivariable analysis. Statistical significance was declared at P<0.05 and findings were presented using texts and tables. Results: A total of 210 newborns (70 cases and 140 controls) and their mothers were included with an overall response rate of 98.5%. Antepartum hemorrhage [AOR=7.17; 95% CI 1.73-29.72], low birth weight [AOR=2.87; 95% CI 1.01-8.13], preterm birth [AOR=3.4; 95% CI 1.04-11.16], caesarean section delivery [AOR=2.75; 95% CI 1.01-7.42], instrumental delivery [AOR=4.88; 95% CI 1.35-17.61], fetal distress [AOR=4.77; 95% CI 1.52-14.92] and meconium-stained amniotic fluid [AOR=9.02; 95% CI 2.96-30.24] were significantly associated with perinatal asphyxia. Hence, efforts ought to go to improve the quality of antenatal and intra-natal services.
Pan African Medical Journal
Introduction: globally, intrapartum stillbirth accounts for 1 million deaths of babies annually, representing approximately one-third of global stillbirth toll. Intrapartum stillbirth occurs due to causes ranging from maternal medical and obstetric conditions; access to quality obstetric care services during pregnancy; and types, timing and quality of intrapartum care. Different medical conditions including hypertensive & metabolic disorders, infections and nutritional deficiencies during pregnancy are among risk factors of stillbirth. Ethiopia remains one of the 10 high-burden stillbirth countries with estimated rate of more than 25 per 1000 births. Methods: a case-control study using primary data from chart review of medical records of women who experienced intrapartum stillbirth in 23 public health facilities of Addis Ababa during the period July 1, 2010-June 30, 2015 was conducted. Data was collected from charts of all cases of intrapartum stillbirth meeting the inclusion criteria and randomly selected charts of controls in two to one (2:1) control to case ratio. Results: chronic medical conditions including diabetes, cardiac and renal diseases were less prevalent (1%) among the study population whereas only 6% of women experienced hypertensive disorder during the pregnancy in review. Moreover, 6.5% of the study population had HIV infection where being HIV negative was protective against intrapartum stillbirth (aOR 0.37, 95% CI 0.18-0.78). Women with non-cephalic foetal presentation during last ANC visit were three times more at risk of experiencing intrapartum stillbirth whereas singleton pregnancy had strong protective association against intrapartum stillbirth (p<0.05). Conclusion: untreated chronic medical conditions, infection, poor monitoring of foetal conditions and multiple pregnancy are among important risk factors for intrapartum stillbirth.
Maternal Health, Neonatology and Perinatology, 2021
Background Globally over 2.6 million pregnancy ends with stillbirth annually. Despite this fact, only a few sherds of evidence were available about factors associated with stillbirth in Ethiopia. Therefore, the study aimed to spot factors related to stillbirth among women who gave birth at Hawassa University Comprehensive Specialized Hospital Hawassa, Sidama Ethiopia, 2019. Methods Facility-based unmatched case-control study was conducted at Hawassa University Comprehensive Specialized Hospital. Cases were selected using simple random sampling technique and controls were recruited to the study consecutively after every case selection with case to control ratio of 1 to 3. Data were coded and entered into Epi-data version 3.1 and exported to SPSS version 24 for analysis. Results A total of 106 cases and 318 controls were included in the study. Number of antenatal care visit [AOR = 0.38, 95% CI (0.15, 0.95)], lack of partograph utilization [AOR = 4.1 95% CI (2.04, 10.5)], prolonged lab...
Determinants of Intrapartum Still Birth and Early Neonatal Death in a Periurban Hospital
Bangladesh Journal of Obstetrics & Gynaecology
Stillbirth and early neonatal death is quite high in Bangladesh. The current study was undertaken to find out sociodemographic and pregnancy related risk factors that may exist with cases of stillbirth and death during first 7 days of life. This was a cross sectional study conducted at Institute of Child and mother health (ICMH) between February to June 2015. Mothers delivered still birth baby at ICMH and whose babies were admitted in neonatal ward immediately after birth for delay to cry were enrolled consecutively. Data was collected by interviewing mothers and reviewing hospital records using structured questionnaire. Follow up was done till 7 days. Data analysis was done with SPSS version 14 Among a total 116 mothers 83.6% came from rural areas, 48.2% belong to 20-25 years age group with mean age 23±5 year, 46.6% had primary education, 89.7% were primipara, and 62.9% had more than 4 antenatal visits in index pregnancy. Common pregnancy related problems were anaemia (85.3%), pree...
Scientific Reports, 2022
Birth asphyxia is a leading cause of neonatal deaths, which accounts for about 31.6% of all neonatal deaths in Ethiopia. Despite its being one of the important causes of morbidity and mortality in newborns, its determinants were not investigated according to local context. So, this study was aimed at investigating the determinants of asphyxia at Illu Aba Bor zone public health facilities. An institution-based case-control study was employed. A pre-tested, structured and adapted interviewer administered questionnaire for mothers of newborn interviews and a data extraction tool for chart review were used. The collected data were entered into Epi-data version 3.1 and exported to SPSS version 24 for further analysis. A binary logistic regression was employed, and variables with a p-value < 0.25 were taken to a multi-variable logistic regression. Finally, a Bonferroni correction was used and variables with a p-value < 0.0038 at 95% CI were declared statistically significant. A total of 308 (103 cases vs 205 controls) mothers of newborns were interviewed, yielding a response rate of 100%. The mean age (SD) of mothers for the cases and the controls were (25.97 ± 4.47) and (25.52 ± 4.17) respectively. Prolonged duration of labor [AOR 4.12; 95% CI 1.78, 9.50], non-cephalic fetal presentation [AOR 4.35; 95% CI 1.77, 10.67], being preterm [AOR 5.77; l95% CI 2.62, 12.69] and low birth weight [AOR 4.43; (95% CI 1.94, 10.13) were found to be the determinants of birth asphyxia. Prolonged duration of labor, non-cephalic presentation, prim parous, preterm, and low birth weight were the independent determinants of birth asphyxia. Hence, improving the utilization of parthograph during labor and interventions focusing on this area should give priority to reducing the risk of morbidity and mortality.