Badimsuguru Adam Bukari, Nyarko Kofi Mensah, Afari Edwin Andrew, Sackey Samuel Oko, Kubio Chrysantus
Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana; Ghana Health Service, Northern Regional Health Directorate, Tamale, Ghana.
Ghana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana.
Pan Afr Med J. 2016 Oct 1;25(Suppl 1):18. doi: 10.11604/pamj.supp.2016.25.1.6168. eCollection 2016.
Stillbirths are more common than the death of a baby after birth. In 2012, Tamale Metropolitan Area in the Northern Region of Ghana reported 35 stillbirths per 1,000 deliveries. This study was therefore conducted to determine the sociodemographic, obstetric and maternal medical health related risk factors associated with stillbirths.
A 1:1 unmatched case control study was conducted in the Tamale Metropolis. Cases were defined as singleton lifeless babies delivered by resident mothers in Tamale Metropolis at or after 28 weeks of gestation from 1st January, 2012 to 31st December, 2013. Controls were those who had live babies within the same period. We abstracted data from maternal health record booklets used in index pregnancies. We also conducted personal interviews with mothers on home visits. We estimated both crude and adjusted odds ratios, 95% confidence intervals and p values.
A total of 368 mothers (184 cases and 184 controls) participated in the study. Maternal age of ≤ 24 years, prolonged labour (> 12 hours) and diastolic blood pressure of less than 80mmHg in late pregnancy were significant determinants of stillbirths (aOR = 3.0, 95% CI 1.08 - 8.39; aOR = 3.5, 95% CI 1.94 - 6.61; aOR =2.2, 1.04 - 4.54 respectively).
Low diastolic blood pressure in late pregnancy, young maternal age and prolonged labour were the key determinants of stillbirths in the Tamale Meetropolis. Improvement of community moral practices and discouraging early marriage will help reduce the menace of stillbirths. Monitoring of blood pressure and labour should be prioritized.
死产比婴儿出生后死亡更为常见。2012年，加纳北部地区的塔马利都会区报告称，每1000例分娩中有35例死产。因此，开展本研究以确定与死产相关的社会人口统计学、产科和孕产妇医疗健康风险因素。
在塔马利都会区进行了一项1:1非匹配病例对照研究。病例定义为2012年1月1日至2013年12月31日在塔马利都会区妊娠28周及以后由常住母亲分娩的单胎死婴。对照为同期分娩活婴的母亲。我们从索引妊娠中使用的孕产妇健康记录手册中提取数据。我们还在家庭访视时对母亲进行了个人访谈。我们估计了粗比值比和调整后的比值比、95%置信区间和p值。
共有368名母亲（184例病例和184例对照）参与了本研究。孕产妇年龄≤24岁、产程延长（>12小时）和妊娠晚期舒张压低于80mmHg是死产的重要决定因素（调整后的比值比分别为3.0，95%置信区间1.08 - 8.39；3.5，95%置信区间1.94 - 6.61；2.2，1.04 - 4.54）。
妊娠晚期舒张压低、孕产妇年龄小和产程延长是塔马利都会区死产的关键决定因素。改善社区道德规范并劝阻早婚将有助于减少死产的威胁。应优先监测血压和产程。
