Identification of factors associated with stillbirth in Zimbabwe – a cross sectional study (original) (raw)
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BMC pregnancy and childbirth, 2005
BACKGROUND: Death of an infant in utero or at birth has always been a devastating experience for the mother and of concern in clinical practice. Infant mortality remains a challenge in the care of pregnant women worldwide, but particularly for developing countries and the need to understand contributory factors is crucial for addressing appropriate perinatal health. METHODS: Using information available in obstetric records for all deliveries (17,072 births) at Harare Maternity Hospital, Zimbabwe, we conducted a cross-sectional retrospective analysis of a one-year data, (1997-1998) to assess demographic and obstetric risk factors for stillbirth and early neonatal death. We estimated risk of stillbirth and early neonatal death for each potential risk factor. RESULTS: The annual frequency of stillbirth was 56 per 1,000 total births. Women delivering stillbirths and early neonatal deaths were less likely to receive prenatal care (adjusted relative risk [RR] = 2.54; 95% confidence interv...
Stillbirth rate and causes in a low-resource setting, Mpilo Central Hospital, Bulawayo, Zimbabwe
Tropical Doctor, 2018
A global concern is to end preventable stillbirths by the year 2030. The objective of this study was to document the stillbirth rate and causes of stillbirths in a low-resource setting. This was a retrospective descriptive study carried out at Mpilo Central Hospital, a tertiary teaching referral government hospital in Bulawayo, Zimbabwe during the period January to December 2016. There were 8801 live births and 268 stillbirths (rate: 30.5/1000). The majority(81.3%) were macerated. Pre-term labour, pre-eclampsia, eclampsia and abruptio placenta accounted for 51.1%. In 29.9%, the cause could not be identified. A high proportion of macerated stillbirths were unexplained; hence this calls for a renewed focus on community-based approaches to reduce delays in seeking care. Investment in robust diagnostic means and further training of healthcare workers to improve case definition are both urgently required.
Paediatric and Perinatal Epidemiology, 2004
Data on birth outcomes are important for planning maternal and child health care services in developing countries. Only a few studies have examined frequency of birth outcomes in Zimbabwe, none of which has jointly examined the spectrum of poor birth outcomes across important demographic subgroups. We assessed delivery patterns and birth outcomes in 17 174 births over a one-year period from October 1997 to September 1998 at Harare Hospital, Zimbabwe. The annual rate of stillbirth was 61 per 1000 live births, rate of preterm birth ( < 37 weeks) was 168 per 1000, and low birthweight (LBW) ( < 2500 g) was 199 per 1000. Not attending antenatal care (prenatal care) was associated with increased risks of stillbirth [relative risk (RR) = 2.54, 95% CI 2.21, 2.92], preterm delivery [RR = 2.43, 95% CI 2.26, 2.61] and LBW births [RR = 2.16, 95% CI 2.02, 2.31]. Preterm births and LBW births were more likely to be stillborn [RR = 7.26, 95% CI 6.28, 8.39 and RR = 6.85, 95% CI 5.94, 7.91]. In conclusion, the rate of stillbirth is high and is predominantly associated with preterm births and to a lesser extent LBW. Reducing the frequency of stillbirth will require a better understanding of the determinants of preterm births and strategies for addressing this particular subset of high-risk births.
Determinants of stillbirth in the Five General Hospitals of Lusaka, Zambia: A Case-Control study
Medical journal of Zambia, 2023
Objective: We aimed to assess determinants of stillbirths among women who delivered from the five general hospitals of Lusaka city, Zambia. Methods: We conducted an unmatched case-control study. Cases were consecutively enrolled, and controls were randomly selected within 24 hours of occurrence of a case. A structured questionnaire was used to collect data, and multiple regression was used to assess determinants of stillbirths. A p-value of <0.05 was considered sufficient evidence of an association between stillbirth and independent variables. Results: A total of 58 cases and 232 controls were included in the analysis. Compared with women who delivered babies with birth weight <2500 grams, the risk of stillbirth for women who had babies with birth weight 2500 was higher (AOR= 4.49; 95% CI: 2.84-8.99); antepartum haemorrhage (AOR = 3.18; 95% CI: 1.21-8.09); previous experience of stillbirth (AOR=3.99; 95% CI: 1.73-6.73) compared with their counterparts without. Additionally, women with parity > 2 (AOR = 3.02; 95% CI: 1.07-7.54) had higher odds of stillbirth compared to those with parity 2. Conclusion: Birth weight 2.5 kg, antepartum haemorrhage, previous stillbirth were determinants of stillbirth. Program implementers should consider strategies that can mitigate these determinants to reduce stillbirth.
Reproductive health, 2018
Stillbirth rates remain high, especially in low and middle-income countries, where rates are 25 per 1000, ten-fold higher than in high-income countries. The United Nations' Every Newborn Action Plan has set a goal of 12 stillbirths per 1000 births by 2030 for all countries. From a population-based pregnancy outcome registry, including data from 2010 to 2016 from two sites each in Africa (Zambia and Kenya) and India (Nagpur and Belagavi), as well as sites in Pakistan and Guatemala, we evaluated the stillbirth rates and rates of annual decline as well as risk factors for 427,111 births of which 12,181 were stillbirths. The mean stillbirth rates for the sites were 21.3 per 1000 births for Africa, 25.3 per 1000 births for India, 56.9 per 1000 births for Pakistan and 19.9 per 1000 births for Guatemala. From 2010 to 2016, across all sites, the mean stillbirth rate declined from 31.7 per 1000 births to 26.4 per 1000 births for an average annual decline of 3.0%. Risk factors for stillbi...
Predisposing factors associated with stillbirth in Tanzania
International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics, 2015
To determine whether specific medical conditions and/or fetal compromise during labor are associated with fresh stillbirth (FSB), and whether absent fetal heart rate (FHR) before delivery can increase risk of FSB. An observational cohort study was conducted at three university referral hospitals in Tanzania between January and September 2013. Maternal, labor, and neonatal characteristics were recorded for all deliveries. FSB was defined as an Apgar score of 0 at 1 and 5minutes, with intact skin and suspected death during labor or delivery. Among 15 305 deliveries, there were 499 stillbirths (243 FSBs and 256 macerated stillbirths). Stillbirth was significantly more likely than a live birth after maternal transfer (odds ratio [OR] 3.27; 95% confidence interval [CI] 2.73-3.92; P<0.001) and when FHR was absent (OR 996.29; 95% CI 632.19-1570.09; P<0.001). Risk of stillbirth increased with uterine rupture (OR 138.62; 95% CI 60.73-316.44), placental abruption (OR 40.96; 95% CI 28.97...
Determinants of stillbirths in Northern Ghana: a case control study
Pan African Medical Journal, 2016
Introduction: stillbirths are more common than the death of a baby after birth. In 2012, Tamale Metropolitan Area in the Northern Region of Ghana reported 35 stillbirths per 1,000 deliveries. This study was therefore conducted to determine the sociodemographic, obstetric and maternal medical health related risk factors associated with stillbirths. Methods: a 1:1 unmatched case control study was conducted in the Tamale Metropolis. Cases were defined as singleton lifeless babies delivered by resident mothers in Tamale Metropolis at or after 28 weeks of gestation from 1st January, 2012 to 31st December, 2013. Controls were those who had live babies within the same period. We abstracted data from maternal health record booklets used in index pregnancies. We also conducted personal interviews with mothers on home visits. We estimated both crude and adjusted odds ratios, 95% confidence intervals and p values. Results: a total of 368 mothers (184 cases and 184 controls) participated in the study. Maternal age of ≤ 24 years, prolonged labour (> 12 hours) and diastolic blood pressure of less than 80mmHg in late pregnancy were significant determinants of stillbirths (aOR = 3.0, 95% CI 1.08-8.39; aOR = 3.5, 95% CI 1.94-6.61; aOR =2.2, 1.04-4.54 respectively). Conclusion: low diastolic blood pressure in late pregnancy, young maternal age and prolonged labour were the key determinants of stillbirths in the Tamale Meetropolis. Improvement of community moral practices and discouraging early marriage will help reduce the menace of stillbirths. Monitoring of blood pressure and labour should be prioritized.
PLOS ONE
Background Maternal and Child health remains at the core of global health priorities transcending the Millennium Development Goals into the current era of Sustainable Development Goals. Most low and middle-income countries including Ghana are yet to achieve the required levels of reduction in child and maternal mortality. This paper analysed the trends and the associated risk factors of stillbirths in a district hospital located in an impoverished and remote region of Ghana. Methods Retrospective hospital maternal records on all deliveries conducted in the Navrongo War Memorial hospital from 2003-2013 were retrieved and analysed. Descriptive and inferential statistics were used to summarise trends in stillbirths while the generalized linear estimation logistic regression is used to determine socio-demographic, maternal and neonatal factors associated with stillbirths. Results A total of 16,670 deliveries were analysed over the study period. Stillbirth rate was 3.4% of all births. There was an overall decline in stillbirth rate over the study period as stillbirths declined from 4.2% in 2003 to 2.1% in 2013. Female neonates were less likely to be stillborn (Adjusted Odds ratio = 0.62 and 95%CI [0.46, 0.84]; p = 0.002) compared to male neonates;
Determinants of adverse pregnant outcomes in Mutare district clinics,Manicaland Province, Zimbabwe
2015
78 Background: Perinatal deaths are adverse pregnancy outcomes that account for 79 about 7% of global burden of disease, with developing countries contributing about 80 98% of deaths. This study aimed at determining the factors associated with adverse 81 pregnancy outcomes among women at Sakubva hospital, Mutare district, Zimbabwe 82 from January to June 2014. 83 Methods: A retrospective review of 346 patient records, of women who delivered at 84 Sakubva hospital and those referred from Mutare district facilities to Mutare 85 Provincial Hospital, between January and June 2014. Multilevel logistic regression 86 using a backward hierarchical approach was performed to compare twenty-four 87 variables associated with outcome. Variables with more than 80% data available 88 were considered for analysis. Stata 12.0 was used to analyse the data. 89 Results: Of the 346 women included in this study, 54 (15.61%) experienced an 90 adverse pregnancy outcome (stillbirth or early neonatal death). ...