Maternal and fetal risk factors for stillbirth in Otjozondjupa Region, Namibia: a case-control study

Abstract

Introduction: stillbirth is defined as a baby born with no signs of life. Globally, around 3.2 million stillbirths occur annually, of which, 98% are experienced in low and middle-income countries. Otjozondjupa Region topped the list of regions with high burden of stillbirth in Namibia in 2016. This study sought to elucidate risk factors for stillbirth.

Methods: an unmatched 1:2 case-control study was conducted. A sample of 285, 95 cases and 190 controls were chosen using simple random sampling method. Bivariate and multivariate analyses were done to assess the risk factors of stillbirth.

Results: maternal medical and obstetric factors significantly associated with stillbirth are: premature delivery (aOR 0.13 95% CI 0.05, 0.33, P < 0.001), gestational age (aOR 0.04, 95% CI 0.00, 0.25, P < 0.001), high-risk pregnancy (aOR 3.59, 95% CI 1.35, 9.55, P = 0.01), duration of labor (aOR 4.04, 95% CI 1.56, 10.43, P = 0.003) and antenatal care (ANC) attendance (aOR 0.07, 95% CI 0.00, 0.79, P = 0.03). Only low birth weight (≤ 2500 g) was associated with stillbirth amongst fetal related factors (aOR 16.58, 95% CI 8.71, 31.55, P < 0.001).

Conclusion: this study concludes that stillbirth in Otjozondjupa Region was mostly associated with maternal medical and obstetric factors. It also concluded that attending antenatal care in Otjozondjupa did not improve birth outcome.