Abstract
BackgroundIn 2015, Nigeria’s estimated 317,700 stillbirths accounted for 12.2% of the 2.6 million estimated global stillbirths. This suggests that Nigeria still makes substantial contribution to the global burden of stillbirths. This study was conducted to determine the prevalence and identify the causes and factors associated with stillbirth in eight referral hospitals in Nigeria.MethodsThis was a cross-sectional study of all deliveries over a period of 6 months in six general hospitals (4 in the south and 2 in the north), and two teaching hospitals (both in the north) in Nigeria. The study population was women delivering in the hospitals during the study period. A pre-tested study protocol was used to obtain clinical data on pregnancies, live births and stillbirths in the hospitals over a 6 months period. Data were analyzed centrally using univariate, bivariate and multivariate logistic regression analyses. The main outcome measure was stillbirth rate in the hospitals (individually and overall).ResultsThere were 4416 single births and 175 stillbirths, and a mean stillbirth rate of 39.6 per 1000 births (range: 12.7 to 67.3/1000 births) in the hospitals. Antepartum (macerated) constituted 22.3% of the stillbirths; 47.4% were intrapartum (fresh stillbirths); while 30.3% was unclassified. Acute hypoxia accounted for 32.6% of the stillbirths. Other causes were maternal hypertensive disease (6.9%), and intrapartum unexplained (5.7%) among others. After adjusting for confounding variables, significant predictors of stillbirth were referral status, parity, past experience of stillbirth, birth weight, gestational age at delivery and mode of delivery.ConclusionWe conclude that the rate of stillbirth is high in Nigeria’s referral hospitals largely because of patients’ related factors and the high rates of pregnancy complications. Efforts to address these factors through improved patients’ education and emergency obstetric care would reduce the rate of stillbirth in the country.Trial registrationTrial Registration Number NCTR91540209.Nigeria Clinical Trials Registry. http://www.nctr.nhrec.net/Registered April 14th 2016.
Highlights
In 2015, Nigeria’s estimated 317,700 stillbirths accounted for 12.2% of the 2.6 million estimated global stillbirths
More than onethird (39.7%) of the births were by mothers who were not booked for antenatal care, while 8.7% of them were referred to the health facility from home, traditional births attendants (TBAs) and other health facilities
5.2% of the births were by mothers who had stillbirths in the past
Summary
In 2015, Nigeria’s estimated 317,700 stillbirths accounted for 12.2% of the 2.6 million estimated global stillbirths [3]. While much emphasis is being given to reducing the high rate of maternal mortality in the country, very limited efforts have been concentrated on reducing the rate of stillbirth. This is possibly due to the non-inclusion of rates of stillbirth in measuring the achievement of the Millennium Development Goals and the Sustainable Development Goals, to which the country is devoting priority policy attention. It has been recognized that it is important to make stillbirth visible, recognized and counted [2]
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