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Risk factors associated with stillbirths among women delivered at Muhimbili National Hospital, Tanzania: Unmatched case-control study


Joseph Dickson Katumba
Clement Nyamunura Mweya
Peter Wangwe

Abstract

Background: Tanzania ranks among the top ten countries globally for the highest number of stillbirths. Risk factors associated with stillbirth are often vague and differ across settings. Little is known about whether these factors drive the high stillbirth rate in Tanzania. The study aimed to identify the risk factors associated with stillbirths at a major healthcare facility in the country.
Methods: An unmatched case-control study was conducted in 2017 involving 146 cases and 292 controls of women who delivered stillbirths and live babies, respectively. Structured questionnaires and clinical checklists collected socio-demographic, maternal health, and obstetric data. Bivariate analysis using chi-square tests identified associations between variables and stillbirth occurrence. Logistic regression analysis determined independent risk factors for stillbirth.
Results: During the study period, 2537 newborns were delivered. Stillbirths were 153, giving a stillbirth rate of 60 per 1000 total live births. Factors that were independently associated with stillbirth after controlling for potential confounders were gestational hypertension (AOR=2.3; 95%CI: 1.1- 4.6), preeclampsia (AOR=3.0; 95%CI: 1.5- 5.8), previous history of stillbirth (AOR=3.5; 95%CI: 1.7- 6.9), intrauterine growth restriction (AOR=3.2; 95%CI: 1.4-7.1), antepartum hemorrhage (AOR=20.5; 95%CI: 7.5-56.0) and fetal distress (AOR=3.3; 95%CI: 1.5-7.6).
Conclusion: Hypertensive disorders in pregnancy and antepartum haemorrhage are critical risk factors associated with a stillbirth at Muhimbili National Hospital that require timely management. Improved intrapartum monitoring using tools like a partograph could help prevent stillbirths. Local research is vital to identify setting-specific factors associated with stillbirth to reduce the substantial stillbirth burden in developing countries like Tanzania.


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eISSN: 1821-9241
print ISSN: 1821-6404