Intrauterine Fetal Death in the Third Trimester of Pregnancy in Kamina, DR Congo: Identification of High-Risk Mothers and Impact of the Periodicity of Antenatal Care

Abstract

Purpose: Intrauterine fetal death (IUFD) is a problem frequently encountered in obstetrical practice in developing countries. The objectives of this study were to identify maternal risk factors for IUFD in the third trimester of pregnancy and to establish its relationship with the norms of periodicity of antenatal care in Kamina. Materiel and methods: This is a case-control study conducted in 6 health facilities in Kamina from January 2021 to May 2022. The effects of the socio-demographic characteristics and obstetrical history of mothers, number of prenatal attendances, age of pregnancy at the first prenatal attendance and number of consultations in third trimester of pregnancy on the occurrence of IUFD were studied. A total of 78 cases of IUFD were linked to 234 controls. Results: The adjustment allowed us to retain 5 parameters significantly associated with IUFD: residence in a rural environment (aOR=2.25; CI= [1.23-4.48]), absence of a history of abortion (aOR=2.97; CI=[1.21-7.26]), history of stillbirth (aOR=2.97; CI =[1.21-7.26]), non-follow up of prenatal care (aOR=3.69; CI=[1.78-7.68]) and insufficient number of prenatal attendances in the third trimester of pregnancy (aOR= 2.22; CI=[1.04 -4.73]). The values of the area under the ROC curve (AUC) found indicate a good capacity of the model (80.3%). Conclusion: The modifiable maternal determinants and those related to identified ANC should serve providers to reduce the occurrence of IUFD in Kamina and its surroundings.