Abstract
Abstract Objectives: to identify the determinants of stillbirths in Zambezia province, Mozambique. Methods: a retrospective cross-sectional ecological study was carried out in 2013-2014 by using perinatal indicators captured by the health information system in Zambezia. Sequentially perinatal care indicators, bivariate analysis and multiple adjusted regression at a 5% significance level with possible explainable variables of stillbirths were described. Results: a median proportion of stillbirths was 1.6%, low birth weight and preterm birth and obstetric complications were 4.9%, 1.9% and 4.1%, respectively. The bivariate analysis demonstrated association of stillbirths with anemia (p=0.043), antepartum hemorrhage (p=0.009), dystocic delivery (p<0.001), obstructed labor (p=0.004). In the analysis of multiple adjusted regression, the obstructed labor were a predictor (ß=0.435; p=0.03) to stillbirths Conclusions: the most important factor associated to stillbirths in health facilities in Zambezia province in 2013-2014 was the obstructed labor. The strengthening of diagnostic analysis and the attempt to handle obstetric complications is still a priority in Zambezia, in being able to decrease the avoidable perinatal deaths.
Highlights
In Mozambique, the fetal mortality rate is determined by the number of fetal deaths that occurred on the 28th week of gestation or the fetuses with an equal weight or greater than 1500g per one thousand total live births in a population residing in a given geographical space, in the considerate year
The instruments for the data collection in the maternity are standardized throughout the country, constituting in: demands of file books and follow-ups on patients at the maternity; clinical obstetrics files containing flowcharts on partogram according to the standards of the World Health Organization (WHO); monthly summary forms resulting on care and perinatal health indicators.[13]
The occurrence of stillborns was significantly correlated with the indicators of anemia (Pearson's coefficient 0.429; p=0.043), antepartum hemorrhage (Pearson’s coefficient 0.56; p=0.009), dystocic delivery (Pearson’s coefficient 0.85; p
Summary
In Mozambique, the fetal mortality rate is determined by the number of fetal deaths that occurred on the 28th week of gestation or the fetuses with an equal weight or greater than 1500g per one thousand total live births in a population residing in a given geographical space, in the considerate year. This rate is one of the main indicators of the quality in the health services that are provided during pregnancy and childbirth.[1]. The rate of stillbirths decreased from 22.1 per thousand births in 1995 to 18.9 per thousand in 2009, the largest proportion, approximately 72.2%, occurred in South Asia and in the SubSaharan Africa.[2,3] Despite the decreased trend, the number of stillbirths remains unacceptably high
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