Abstract
IntroductionIn spite of free caesarean section applied in Benin since 2009, high rates of stillborn babies continue to be recorded. This study aimed to determine the factors associated with post-caesarean stillborn in Benin.MethodsCross-sectional study that covered all women who have delivered by caesarean from December 2013 to February 2014 in twelve hospitals chosen by simple random selection in each of the twelve departments of Benin. Data collected by chart review have been analyzed using the statistical software Epi info 3.5.1. Univariate analysis and multivariable logistic regression were used to identify factors associated with post-caesarean stillbirth at the significance threshold of 5%.ResultsThere were 66 stillborn per 1,000 births of which 58% died before admission to hospital. The risk factors identified were the reference (p = 0.0011), general anesthesia (p = 0.0371), the low birth weight (p = 0.0001), the retro-placental hematoma (p = 0.0083), and the umbilical cord prolapse (p = 0.0229). Acute fetal distress (p = 0.0308) and anesthesia administered by an anesthetist nurse or midwife (p = 0.0337) were protective factors.ConclusionThe majority of cases, in utero death occurred before admission to hospital. Strengthening antenatal refocused consultation, a better access to quality obstetric care and the grant of all obstetric care could reduce stillbirths from caesarean sections in Benin.
Highlights
Worldwide, each year there are about 2.65 million stillborn in the third trimester of pregnancy, of which 98% in the Low and Middle Income Countries (LMIC) [1]
A higher proportion of these stillborn babies is recorded during childbirth in the LMIC [1, 2], where about half of the pregnancies have reached term, with viable babies if they benefited from better care [1]
As this free caesarean policy aimed at reducing morbidity and infant and maternal mortality and that post-caesarean stillbirth was little published compared to the overall stillbirth [1,2,3, 7], this study was initiated to describe stillborn babies from the caesarean and to determine their associated factors in Benin
Summary
Each year there are about 2.65 million stillborn in the third trimester of pregnancy, of which 98% in the Low and Middle Income Countries (LMIC) [1]. In 2013, as part of data collection from a study on the quality of caesarean section performed in 12 hospitals, 6.6% stillbirth following a caesarean section had caught our attention. As this free caesarean policy aimed at reducing morbidity and infant and maternal mortality and that post-caesarean stillbirth was little published compared to the overall stillbirth [1,2,3, 7], this study was initiated to describe stillborn babies from the caesarean and to determine their associated factors in Benin
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