Determinants of Stillbirth Among Deliveries Attended in Bale Zone Hospitals, Oromia Regional State, Southeast Ethiopia: A Case–Control Study

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Abstract

Background

Stillbirth is one of the adverse outcomes of pregnancy, and it is among the major public health problems in developing countries including Ethiopia. Stillbirth has wide-reaching consequences for parents, care providers, community and society at large.

Purpose

To assess the determinant of stillbirth among deliveries attended in Bale zone hospitals Southeast Ethiopia.

Methods

An institution-based unmatched case–control study was conducted. Cases were deliveries whose birth outcome was stillbirth and controls were deliveries with live birth. A pretested and structured checklist was used to collect data from a sample of 402 (134 cases and 268 controls). Systematic random sampling was used to recruit samples from a list of charts in the delivery registration book. Data were entered into EpiData version 4.2 and exported to SPSS version 20 for analysis. Crude and adjusted odds ratio with 95%CI was calculated and P-value <0.05 was used to declare statistical significance.

Results

A total of 402 charts of mothers (134 cases and 268 controls) were included in the analysis. Preceding birth interval <24 months (AOR: 2.991; 95%CI: 1.351–6.621), antenatal visit started at third trimester (AOR: 2.739; 95%CI: 1.048–7.158), referred from other health facility (AOR: 3.215; 95%CI: 1.430–7.229), labor length ≥24 h (AOR: 3.169; 95%CI: 1.241–8.091), presence of meconium stained amniotic fluid (AOR: 2.670; 95%CI: 1.082–6.592) and giving birth to a baby <2500 g (AOR: 3.155; 95%CI: 1.235–8.07) were determinants of stillbirth.

Conclusion

Preceding birth interval of <24 months, antenatal visit started at third trimester, referred from other health facility, presence of meconium stained amniotic fluid, labor length ≤24 h and giving birth to a baby <2500 g were found the determinants of stillbirth. Intrapartum care, early identification of labor complications and referral system are required.

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Most cited references 23

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Stillbirths: rates, risk factors, and acceleration towards 2030

Joy E. Lawn, Hannah Blencowe, Peter Waiswa … (2016)

An estimated 2.6 million third trimester stillbirths occurred in 2015 (uncertainty range 2.4-3.0 million). The number of stillbirths has reduced more slowly than has maternal mortality or mortality in children younger than 5 years, which were explicitly targeted in the Millennium Development Goals. The Every Newborn Action Plan has the target of 12 or fewer stillbirths per 1000 births in every country by 2030. 94 mainly high-income countries and upper middle-income countries have already met this target, although with noticeable disparities. At least 56 countries, particularly in Africa and in areas affected by conflict, will have to more than double present progress to reach this target. Most (98%) stillbirths are in low-income and middle-income countries. Improved care at birth is essential to prevent 1.3 million (uncertainty range 1.2-1.6 million) intrapartum stillbirths, end preventable maternal and neonatal deaths, and improve child development. Estimates for stillbirth causation are impeded by various classification systems, but for 18 countries with reliable data, congenital abnormalities account for a median of only 7.4% of stillbirths. Many disorders associated with stillbirths are potentially modifiable and often coexist, such as maternal infections (population attributable fraction: malaria 8.0% and syphilis 7.7%), non-communicable diseases, nutrition and lifestyle factors (each about 10%), and maternal age older than 35 years (6.7%). Prolonged pregnancies contribute to 14.0% of stillbirths. Causal pathways for stillbirth frequently involve impaired placental function, either with fetal growth restriction or preterm labour, or both. Two-thirds of newborns have their births registered. However, less than 5% of neonatal deaths and even fewer stillbirths have death registration. Records and registrations of all births, stillbirths, neonatal, and maternal deaths in a health facility would substantially increase data availability. Improved data alone will not save lives but provide a way to target interventions to reach more than 7000 women every day worldwide who experience the reality of stillbirth.

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Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost?

Zulfiqar Bhutta, Jai K Das, Rajiv Bahl … (2014)

Progress in newborn survival has been slow, and even more so for reductions in stillbirths. To meet Every Newborn targets of ten or fewer neonatal deaths and ten or fewer stillbirths per 1000 births in every country by 2035 will necessitate accelerated scale-up of the most effective care targeting major causes of newborn deaths. We have systematically reviewed interventions across the continuum of care and various delivery platforms, and then modelled the effect and cost of scale-up in the 75 high-burden Countdown countries. Closure of the quality gap through the provision of effective care for all women and newborn babies delivering in facilities could prevent an estimated 113,000 maternal deaths, 531,000 stillbirths, and 1·325 million neonatal deaths annually by 2020 at an estimated running cost of US$4·5 billion per year (US$0·9 per person). Increased coverage and quality of preconception, antenatal, intrapartum, and postnatal interventions by 2025 could avert 71% of neonatal deaths (1·9 million [range 1·6-2·1 million]), 33% of stillbirths (0·82 million [0·60-0·93 million]), and 54% of maternal deaths (0·16 million [0·14-0·17 million]) per year. These reductions can be achieved at an annual incremental running cost of US$5·65 billion (US$1·15 per person), which amounts to US$1928 for each life saved, including stillbirths, neonatal, and maternal deaths. Most (82%) of this effect is attributable to facility-based care which, although more expensive than community-based strategies, improves the likelihood of survival. Most of the running costs are also for facility-based care (US$3·66 billion or 64%), even without the cost of new hospitals and country-specific capital inputs being factored in. The maximum effect on neonatal deaths is through interventions delivered during labour and birth, including for obstetric complications (41%), followed by care of small and ill newborn babies (30%). To meet the unmet need for family planning with modern contraceptives would be synergistic, and would contribute to around a halving of births and therefore deaths. Our analysis also indicates that available interventions can reduce the three most common cause of neonatal mortality--preterm, intrapartum, and infection-related deaths--by 58%, 79%, and 84%, respectively. Copyright © 2014 Elsevier Ltd. All rights reserved.

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National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis

Hannah Blencowe, Simon Cousens, Fiorella Bianchi Jassir … (2016)

Previous estimates have highlighted a large global burden of stillbirths, with an absence of reliable data from regions where most stillbirths occur. The Every Newborn Action Plan (ENAP) targets national stillbirth rates (SBRs) of 12 or fewer stillbirths per 1000 births by 2030. We estimate SBRs and numbers for 195 countries, including trends from 2000 to 2015.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Womens Health

Journal ID (iso-abbrev): Int J Womens Health

Journal ID (publisher-id): ijwh

Journal ID (pmc): intjwh

Title: International Journal of Women's Health

Publisher: Dove

ISSN (Electronic): 1179-1411

Publication date (Electronic): 08 January 2021

Publication date Collection: 2021

Volume: 13

Pages: 51-60

Affiliations

[1 ]World Vision Ethiopia , Hawassa, Ethiopia

[2 ]Department of Public Health, Madda Walabu University Goba Referral Hospital School of Health Science , Bale Goba, Ethiopia

Author notes

Correspondence: Abulie Takele Melku Department of Public Health, Madda Walabu University Goba Referral Hospital School of Health Science , PO Box 302, Bale Goba, EthiopiaTel +251911060837 Email Abuletakele@Yahoo.Com

Author information

Abulie Takele Melku http://orcid.org/0000-0002-9076-3268

Adem Abdurkadir Abdi http://orcid.org/0000-0001-5084-7101

Article

Publisher ID: 276638

DOI: 10.2147/IJWH.S276638

PMC ID: 7802824

PubMed ID: 33447092

SO-VID: a36f1c54-1795-40f6-8c35-a24d8bd2fd6c

License:

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

History

Date received : 12 August 2020

Date accepted : 05 December 2020

Page count

Figures: 0, Tables: 6, References: 23, Pages: 10

Funding

Funded by: Funding agencies do not have a role;

Funding agencies do not have a role in the publication of the paper.

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Determinants of Stillbirth Among Deliveries Attended in Bale Zone Hospitals, Oromia Regional State, Southeast Ethiopia: A Case–Control Study

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Most cited references 23

Stillbirths: rates, risk factors, and acceleration towards 2030

Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost?

National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis

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