Abstract

BackgroundAlthough the rate of stillbirth has decreased globally, it remains unacceptably high in low- and middle-income countries. Only ten countries including Ethiopia attribute more than 65% of global burden of still birth. Ethiopia has the 7th highest still birth rate in the world. Identifying the predictors of stillbirth is critical for developing successful interventions and monitoring public health programs. Although certain studies have assessed the predictors of stillbirth, they failed in identify the proximate predictors of stillbirth. In addition, the inconsistent findings in identify the predictors of stillbirth, and the methodological limitations in previously published works are some of the gaps. Therefore, this study aimed to identify the predictors of stillbirth among mothers who gave birth in six referral hospitals in Southern, Ethiopia.MethodsA hospital-based unmatched case-control study was conducted in six referral hospitals in Southern, Ethiopia from October 2019 to June 2020. Consecutive sampling techniques and simple random techniques were used to recruit cases and controls respectively. A structured standard tool was used to identify the predictors of stillbirth. Data were entered into Epi Info 7 and exported to SPSS 23 for analysis. A multivariable logistic regression model was used to identify the independent predictors of stillbirth. The goodness of fit was tested using the Hosmer and Lemeshow goodness-of-fit. In this study P-value < 0.05 was considered to declare a result as a statistically significant association.ResultsIn this study 138 stillbirth cases and 269 controls were included. Women with multiple pregnancy [AOR = 2.98, 95%CI: 1.39–6.36], having preterm birth [AOR = 2.83, 95%CI: 1.58–508], having cesarean mode of delivery [AOR = 3.19, 95%CI: 1.87–5.44], having no ANC visit [AOR = 4.17, 95%CI: 2.38–7.33], and being hypertensive during pregnancy [AOR = 3.43, 95%CI: 1.93–6.06] were significantly associated with stillbirth.ConclusionsThe predictors of stillbirth identified are manageable and can be amenable to interventions. Therefore, strengthening maternal antenatal care utilization should be encouraged by providing appropriate information to the mothers. There is a need to identify, screen, and critically follow high-risk mothers: those who have different complications during pregnancy, and those undergoing cesarean section due to different indications.

Highlights

  • Stillbirth is a global public health problem, especially in Sub- Saharan Africa (SSA) and South Asia [1,2,3,4]

  • Strengthening maternal antenatal care utilization should be encouraged by providing appropriate information to the mothers

  • 138 cases and 269 controls were included with a response rate of 98.5% for both cases, and controls

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Summary

Introduction

Stillbirth is a global public health problem, especially in Sub- Saharan Africa (SSA) and South Asia [1,2,3,4]. The WHO explained stillbirth as fetal death (i.e., death before the complete expulsion or extraction of a product of conception from its mother) in the third trimester ( 28 completed weeks of development) or with birth weight 1000 g or length 35 cm [5,6,7]. It is an indicator of the quality of care during pregnancy and childbirth; institutional deliveries are increasing but stillbirth is not well decreased in the developing world [8,9,10,11]. This study aimed to identify the predictors of stillbirth among mothers who gave birth in six referral hospitals in Southern, Ethiopia

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