Prevalence and Causes of Stillbirths at Lagos University Teaching Hospital, Lagos, Nigeria: A five year review

Abstract

Objective: To determine the prevalence and pattern of stillbirths and identify the clinical causes.
Study design: It was a retrospective descriptive study of all cases of stillbirth managed at Lagos University Teaching Hospital from January 1, 2012 to December 31, 2016. Only cases occurring at 28 weeks gestational age and above were included in this study. Information was retrieved from the Labour Ward register. These included the maternal age, parity, gestational age at delivery, type of stillbirth and pregnancy complications. Data collected was analyzed using SPSS version 20.
Results: During the study period, total birth was 5,721 and total stillbirth reported was 377, making the prevalence of stillbirth 65.9 per 1000 births. Of the stillbirths reported, 35.9% were fresh stillbirths and 64.1% were macerated stillbirths. The commonest causes were hypertensive disorders in pregnancy (10.6%), ruptured uterus (8.5%), abruptio placentae (7.7%), obstructed labour (4.5%), maternal infection (4.0%) and congenital fetal anomaly (3.2%). Although fetal maceration was found to be commoner in the nulliparous women and in women within 26 – 35 years age group, no statistically significant association was found between type of stillbirth and parity (p = 0.3070), maternal age (p = 0.6332) and booking status (p = 0.2819).
Conclusion: The commonest causes of stillbirths are to a great extent avoidable. Good antenatal care and delivery practice by skilled personnel, enforcing the use of partograph at primary and secondary health care centres, encouraging safe sex practice, and establishment of preconception care clinics will help lower prevalence of stillbirth in our environment.

Key words: Stillbirths, prevalence, causes.