Trends of stillbirths in Harare City, Zimbabwe, 2015-2019: a secondary data analysis

Abstract

Introduction: in Zimbabwe, perinatal mortality is a major public health problem. Harare City data showed increase in stillbirth rate trend from 4/1000 live births in 2014 to 6/1000 live births in 2018, failing to meet the country’s target of reducing stillbirth rate by 40%. We analysed the characteristics of stillbirths from 2015 to 2019 in Harare City.

Methods: we conducted a retrospective analytical cross-sectional study using secondary data from Harare City Health Department’s 12 baby-delivery polyclinics. Fourteen key informants were interviewed to verify information obtained. Using Epi-info, descriptive summaries and graphs were generated and bivariate and multivariate logistic regression was conducted. Statistical significance was considered at a p-value <0.05.

Results: a total of 700(74.9%) perinatal death notification records were reviewed. The majority were macerated stillbirths 418(59.7%) followed by fresh stillbirths 189(27.0%). The median age for women who had fresh stillbirths was 26 years (Q₁=22; Q₂=32). Preterm delivery (aOR= 2.15; 95%CI 1.81- 3.89; p<0.01), having delivered by breech presentation (aOR= 3.32; 95%CI 1.72-6.41; p=<0.01), and being HIV positive (aOR= 1.69; 95%CI 1.02-2.79; p=0.04) were associated with preterm delivery.

Conclusion: stillbirths in Harare City were increasing and were due to preventable causes. The younger maternal age group was most affected hence preventive activities should focus on them. Improving the quality of antenatal care, delivery, and new-born care can help reduce stillbirths and early neonatal death.