Risk factors for stillbirths at Universty of Maiduguri teaching hospital, Maiduguri, Nigeria: a cross-sectional retrospective analysis

Abstract

Background:Stillbirth rate is an important indicator of access to and quality of antenatal and delivery care. Data on birth outcomes are important for planning maternal and child health care services in developing countries. There is little or no literature on the stillbirth rate in north-eastern Nigeria. This may be the first study to serve as the baseline data in Maiduguri.
Objective: This study aimed at determining the prevalence and identifying the risk factors contributing to foetal demise. Study design: A cross-sectional retrospective analysis of stillbirth among women delivering in UMTH over a-4 year period, from January 2001 to December 2004. Method: The Case records of 7996 women that delivered in UMTH over the study period were retrieved and the trend of the stillbirth experiences followed up retrospectively, and relevant information with special reference to socio-demographic characteristics, clinical risk factors for stillbirth and type of stillbirth obtained and analyzed. Results: There was a total of 179 stillbirths among the 7996 deliveries giving the institutional prevalence of 22/1000 deliveries. Macerated stillbirths with no obvious congenital malformation predominated (OR: 10.89; CI: 6.51-31.80), accounting for 52.5%, while fresh stillbirths (OR: 5.81; CI: 3.77– 11.87), accounted for 47.5%. Most of the risk factors (63.7%) for stillbirths were present ante partum such as multiparity (OR: 2.88; CI: 1.47-6.09), lack of antenatal care (OR: 1.91; CI: 0.92- 2.05), maternal literacy level (OR: 2.82; CI: 1.44-5.41), hypertension, pre-eclampsia and eclampsia disease complex (c2=15.12; P-value =0.006); while intra partum risk factors contributed 36.3% with SVD as a mode of delivery, the leading risk factor (c2= 23.79; & P-value 0.000). Conclusion: The prevalence of stillbirth is high and is
predominantly associated with ante partum risk factors. In our setting, antenatal care should be considered as the cornerstone in the prevention of stillbirth. With adequate antenatal care and good understanding of the determinants of stillbirth, women with clinical risk factors to stillbirth could be identified and measures to avoid or substantially decrease the occurrence of stillbirth instituted.

Key words: stillbirth, prevalence, aetiologic determinants