Incidence and determinants of stillbirth among women who gave birth in Jimma University specialized hospital, Ethiopia.

Dejene Tilahun,Tsion Assefa

doi:10.11604/pamj.2017.28.299.1269

Abstract

IntroductionWorldwide approximately 2.7 million are stillborn, more than 98% of these occur in developing countries. To address the problem, incidence and determinants of stillbirth must be understood. Therefore the aim of this study was to assess incidence and determinants of stillbirth among women who gave birth in Jimma University specialized hospital.MethodsA cross-sectional study design among 413 mothers who gave birth in Jimma specialized hospital was employed. Study subjects were selected by systematic sampling technique from the list of women who gave birth in hospital in one month study period. Data were collected by using pretested and structured questionnaire. Data were edited, cleaned, coded, entered and analyzed using SPSS-20 statistical software. Univarate and bivariate (logistic regressions) analysis was employed.ResultsThe incidence rate of stillbirth in the Hospital during a month period was 8% or 80 per 1000 total births. The predictors that showed an independent close association with stillbirth were absence of complication (OR = 0.1, 95% CI (0.04-0.2)), referral from other health facility (OR = 0.3, 95% CI (0.1-0.7)), having antenatal care (OR = 0.3, 95% CI (0.1-0.7)) and normal vaginal delivery (OR = 0.2, 95% CI ( 0.1-0.8)).ConclusionThe incidence rate of stillbirths in our setting is high and the identified determinants were related to both ante-partum and intra-partum-period. Therefore, effort should be made to improve antenatal, obstetric services and delivery services in terms awareness, access, timing and referral system to emergency care and specialized service to reduce the number of stillbirths.

Highlights

Worldwide approximately 2.7 million are stillborn, more than 98% of these occur in developing countries
At least 2.7 million stillbirths were estimated worldwide and more than 98% of these occur in low-income and middle-income countries (LAMIC) [1, 2]
The crude analysis indicate that stillbirths were significantly associated with the following factors: Having awareness on unforeseen problems during pregnancy/child birth, Page number not for citation purposes 3 (COR = 0.4, 95% CI (0.2,0.9)), educational status of husband (COR = 3.3, 95% CI (1.6-6.9)), referral from a peripheral health facility (COR = 0.3,95% CI (0.1-0.6)), obstetric complication (COR = 0.1, 95% CI (0.04-0.2)), antenatal care (COR = 0.2, 95% CI (0.1-0.4)), normal vaginal delivery (COR= 0.2, 95% CI (0.1,0.5)) and assisted vaginal delivery (COR = 0.4, 95% CI (0.2-0.9)) (Table 4)

Summary

Introduction

Worldwide approximately 2.7 million are stillborn, more than 98% of these occur in developing countries. To address the problem of still birth in LAMIC, incidence and determinants of stillbirth must be understood This is because incidence of stillbirth is an important indicator of the quality of antenatal and obstetric care [2, 4, 5]. Several studies in LAMIC [6,7,8,9,10,11,12,13,14,15,16,17,18] suggests different determinants for stillbirths These includes lack of adequate access to obstetric care, inadequate care, maternal infections and complications like antepartum bleeding and pregnancy-induced hypertensive disease, poor care during labour and delivery, fetal growth restriction and congenital abnormalities AND socio-demographic characteristics (age, parity, religion, residence and healthcare) are the most important risk factors, while some causal pathways remain unknown. Stillbirth rates can be considered a proxy for access to and quality of reproductive health and ANC services and care during labour and delivery [5]

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Discussion

Conclusion