Prevalence and risk factors for stillbirths in a tertiary hospital in Niger Delta area of Nigeria: a ten year review

Abstract

Background : Stillbirth is a silent but major cause of perinatal mortality and source of foetal wastage. Aim : To determine the prevalence of stillbirth, demographic characteristics and identify the possible risk factors in our Hospital. Methods : This was a ten year cross-sectional retrospective study of stillbirths between 1st January, 2004 and 31st December, 2013. All cases of stillbirths from 28 weeks of gestation or the foetal weight of at least 1000g were included in the study. Results : There were a total of 19,347 deliveries with 937 stillbirths, giving a stillbirth rate of 48.4/1,000 total births or 4.8%. Of the 937 stillbirths identified, only 582 (62.1%) case files could be retrieved and was used for analyses. There were 381(65.5%) macerated and 201(34.5%) fresh stillbirths. Stillbirth rate were higher among grand multiparous women, women with primary education and unbooked women. There were 309(53.1%) male stillbirths and 273(46.9%) female stillbirths. Male foetuses were higher among fresh stillbirth (54.9%) while female foetuses had more macerated stillbirths (48.8%) than fresh stillbirths (45.1%). The major causes of stillbirths were hypertensive disorders of pregnancy (18.9%), prolonged/obstructed labour (13.6%), anaemia in pregnancy (12.2%) and abruption placentae (9.3%). A total of 121(20.8%) of the stillbirths were unexplained. Conclusion : The prevalence of stillbirth in our environment is high. Identified factors such as grandmultiparity, low education, unbooked pregnancy, anaemia in pregnancy, obstructed labour and ruptured uterus are modifiable. Every effort directed at reducing these factors must be made by all healthcare givers including policy makers to reduce stillbirths. Key words: Stillbirth, miscarriage, perinatal mortality, anaemia in pregnancy, obstructed labour, uterine rupture