Are risk factors for stillbirths in low-income countries associated with sensorineural hearing loss in survivors?

OBJECTIVES

To determine associated risk factors for stillbirths in Lagos, Nigeria and to examine possible relationships between these factors and the risk of sensorineural hearing loss (SNHL).

METHODS

Stillbirths in an inner-city maternity hospital from June 2005 to May 2007 were matched with live-birth controls at ratio 1:2. Risk factors and their associated adjusted odds ratio (OR) at 95% confidence interval (CI) were first determined by multiple logistic regression and then correlated with hearing screening failure among survivors who received a two-stage hearing screening with automated otoacoustic emissions and auditory brainstem response.

RESULTS

Of 201 cases examined and matched with 402 live births, 101 (50.2%) were fresh stillbirths and 100 (49.8%) macerated. Multiparity (OR: 1.92; CI: 1.16-3.20), lack of antenatal care (OR: 7.23; CI: 3.94-13.26), hypertensive conditions (OR: 6.48; CI: 2.94-14.29), antepartum haemorrhage (OR:18.84; CI: 6.96-51.00), premature rupture of membrane (OR:3.36; CI: 1.40-8.05), prolonged obstructed labour (OR: 22.25; CI: 10.07-49.16) and prematurity (OR: 2.30; CI: 1.2-4.01) were associated with increased risk of stillbirths whereas caesarean section (OR: 0.24; CI: 0.12-0.48) was associated with lower risk of stillbirths. Infants delivered by mothers with hypertensive conditions during pregnancy were at risk of SNHL (OR: 2.97; CI: 1.15-7.64).

CONCLUSION

Hypertensive conditions during pregnancy increase the risk of stillbirths and place survivors at greater risk of SNHL.