Abstract
BackgroundStillbirths bring grief to both mother and family but have been underreported in Cameroon. We aimed at determining the stillbirth rates and associated risk factors in the Buea Regional Hospital (BRH) and the Limbe Regional Hospital (LRH), Cameroon.Materials and methodsThis was a hospital-based unmatched case-control study in which files of women with stillbirth (cases) were analysed. A woman with a live birth in the same maternity during the same period served as a control. Data were collected using a pre-tested questionnaire. The stillbirth rate was the number of stillbirths per thousand births. Logistic regression analysis was used to identify independent factors associated with stillbirth.ResultsStillbirth rates at the BRH and LRH were 33.72 and 36.45 per 1000 live births. The factors that were independently associated with stillbirth were: referral status (AOR 3.95; 95% CI: 1.85–6.58, p = 0.000), late booking visit - after 12 weeks (AOR 13.64; 95% CI: 1.49–124.83, p = 0.021), preeclampsia (AOR 3.21; 95% CI: 1.23–8.35, p = 0.01), placental abruption (AOR 21.46; 95% CI: 2.36–194.77, p = 0.006), moderate anaemia (AOR 2.04; 95% CI: 1.09–3.83, p = 0.03), labour dystocia (AOR 5.37; 95% CI: 1.77–15.92, p = 0.003), low birth weight (AOR 5.27; 95% CI: 1.48–3.53, p = 0.000), and preterm delivery (AOR 2.81; 95% CI: 1.48–3.35, p = 0.002).ConclusionStillbirth rates are high in both health facilities. Risk factors of stillbirths include referral from another health facility, anaemia, preeclampsia and late booking visit, placental abruption, labour dystocia, preterm birth, and low birth weight. Term, post-term and macrosomia were protective of stillbirth. We recommend electronic data storage in hospitals in Cameroon.
Highlights
A stillbirth represents a death that occurs before the birth of a baby weighing ≥1000 g, or ≥ 28 completed weeks of gestation, or body length ≥ 35 cm (This definition is used for international comparison: the International Classification of Diseases (ICD) of the World Health Organization uses birth weight ≥ 500 g or ≥ 22 completed weeks of gestation, or body length ≥ 25 cm) [1]
The factors that were independently associated with stillbirth were: referral status (AOR 3.95; 95% CI: 1.85–6.58, p = 0.000), late booking visit after 12 weeks (AOR 13.64; 95% CI: 1.49–124.83, p = 0.021), preeclampsia (AOR 3.21; 95% CI: 1.23–8.35, p = 0.01), placental abruption (AOR 21.46; 95% CI: 2.36–194.77, p = 0.006), moderate anaemia (AOR 2.04; 95% CI: 1.09–3.83, p = 0.03), labour dystocia (AOR 5.37; 95% CI: 1.77–15.92, p = 0.003), low birth weight (AOR 5.27; 95% CI: 1.48–3.53, p = 0.000), and preterm delivery (AOR 2.81; 95% CI: 1.48–3.35, p = 0.002)
Factors independently associated with stillbirth after adjusting for confounders The factors that were independently associated with stillbirth were: referral from another health facility (AOR 3.95; 95% CI: 1.85–6.58, p = 0.000), late booking visit after 12 weeks (AOR 13.64; 95% CI: 1.49–124.83, p = 0.021), preeclampsia (AOR 3.21; 95% CI: 1.23–8.35, p = 0.01), placental abruption (AOR 21.46; 95% CI: 2.36–194.77, p = 0.006), moderate anaemia (AOR 2.04; 95% CI: 1.09–3.83, p = 0.03), labour dystocia (AOR 5.37; 95% CI: 1.77–15.92, p = 0.003), low birth weight (AOR 5.27; 95% CI: 2.62– 10.62, p = 0.000), and preterm delivery
Summary
A stillbirth represents a death that occurs before the birth of a baby weighing ≥1000 g, or ≥ 28 completed weeks of gestation, or body length ≥ 35 cm (This definition is used for international comparison: the International Classification of Diseases (ICD) of the World Health Organization uses birth weight ≥ 500 g or ≥ 22 completed weeks of gestation, or body length ≥ 25 cm) [1]. Several studies have been carried out to estimate the rates of stillbirth in different countries. The rates have been shown to vary widely across the globe: in highincome countries, for example, stillbirth rates in 2006 were estimated at 5 per 1000 births, which are quite low compared to about 32 per 1000 births in South Asia and sub-Saharan Africa [5, 7]. In Cameroon, there are few studies on stillbirth, most of which are centred on intrapartum stillbirths [8, 9]. There is a dearth of data on the overall stillbirth rate in Cameroon. This study aimed at assessing the rates and risk factors of stillbirth at BRH and LRH. We aimed at determining the stillbirth rates and associated risk factors in the Buea Regional Hospital (BRH) and the Limbe Regional Hospital (LRH), Cameroon
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