College of Medicine and Health Sciences, School of Public Health, Hawassa University, Hawassa, Ethiopia.
BMC Pregnancy Childbirth. 2020 Oct 6;20(1):591. doi: 10.1186/s12884-020-03296-x.
Stillbirth is an adverse pregnancy outcome of public health importance causing considerable psychosocial burden on parents and their family. Studies on stillbirth are scarce in southern Ethiopia. An assessment of stillbirths and associated factors in health care settings helps in devising strategies for tailored interventions. Therefore, we assessed the burden of stillbirths and associated factors in Yirgalem Hospital, southern Ethiopia.
A facility based cross-sectional study was conducted between 1 and 2015 and 30 July 2016. We randomly selected medical records of pregnant women from a hospital delivery registry. Bivariate analysis was employed to assess the association between independent and dependent variables using chi-square with significant p-value. Multivariate logistic regression was used to identify independent risk factors for stillbirths and to control for confounding variables.
Of 374 reviewed records of pregnant women, 370 were included for the study. The magnitude of stillbirths was 92 per 1000 births. Fifteen (44.1%) of fetal deaths occurred after admission to the hospital. In multivariate logistic regression, stillbirths were higher among low birth-weight babies (< 2500grams) (adjusted odds ratio (AOR): 10.70, 95% CI 3.18-35.97) than normal birth-weight babies (2500-<4000). Pregnant women who experienced a prolonged labour for more than 48 hours were 12 times (AOR: 12.15, 95% CI 1.76-84.12) more likely to have stillbirths than pregnant women without a prolonged labour. Pregnant women with obstetric complications were 18.9 times more likely to have stillbirths than pregnant women without obstetric complications. Similarly, pregnant women with at least two pregnancies were more likely to have stillbirths than pregnant women with less than two pregnancies (AOR: 4.39, 95% CI 1.21-15.85).
We found a high burden of stillbirths in the study setting. Modifiable risk factors contributed to a higher risk of stillbirths; therefore, tailored interventions such as early identification and management of prolonged labour and obstetric complication at each level of health system could avert preventable stillbirths.
死产是一种具有公共卫生重要性的不良妊娠结局，会给父母及其家庭带来相当大的心理社会负担。在埃塞俄比亚南部，关于死产的研究很少。在医疗保健机构中评估死产及其相关因素有助于制定针对特定干预措施的策略。因此，我们评估了埃塞俄比亚南部耶尔加伦医院的死产负担及其相关因素。
这是一项在 2015 年 1 月至 2016 年 7 月 30 日期间在医疗机构进行的横断面研究。我们从医院分娩登记处随机选择了孕妇的病历。使用卡方检验进行了单变量分析，以评估独立和依赖变量之间的关联，具有显著 p 值的变量被认为具有统计学意义。多变量逻辑回归用于确定死产的独立危险因素，并控制混杂变量。
在 374 份孕妇病历中，有 370 份被纳入研究。死产的发生率为每 1000 例活产中有 92 例。15 例（44.1%）的胎儿死亡发生在住院后。在多变量逻辑回归中，低出生体重（<2500 克）的婴儿（校正优势比（AOR）：10.70，95%置信区间（CI）3.18-35.97）比正常出生体重（2500-<4000 克）的婴儿更易发生死产。分娩时间超过 48 小时的孕妇发生死产的可能性是没有分娩时间延长的孕妇的 12 倍（AOR：12.15，95%CI 1.76-84.12）。有产科并发症的孕妇发生死产的可能性是没有产科并发症的孕妇的 18.9 倍。同样，至少有两次妊娠的孕妇发生死产的可能性是少于两次妊娠的孕妇的 4.39 倍（AOR：4.39，95%CI 1.21-15.85）。
我们发现研究环境中死产负担很高。可改变的危险因素增加了死产的风险；因此，在每个卫生系统层面上，对延长的产程和产科并发症进行早期识别和管理等有针对性的干预措施，可以避免可预防的死产。
