Risk Factors of Stillbirth Among Women Who Gave Birth in Amhara Region Referral Hospitals, Ethiopia, in 2019: A Case-Control Study.

BACKGROUND

Worldwide, 2.6 million stillbirths occur annually and more than three-quarters of them are recorded in South Asia and Sub-Saharan Africa. Thus, the aim of this study was to identify risk factors of stillbirth among women who gave birth in Amhara region referral hospitals found in northwest and northcentral, Ethiopia in 2019.

METHODS

A multi-center institution-based unmatched case-control study was conducted among 456 mothers who gave birth in Amhara region referral hospitals from October 1 to December 30, 2019. Consecutive and simple random sampling was used to select the cases and controls, respectively. A semi-structured, interviewer-administered questionnaire and patient chart reviews were used to collect the data. Epidemiological (Epi) data version 4.4.2.1 and Statistical Package for the Social Sciences (SPSS) version 25.0 were used for data entry and analysis, respectively. Binary logistic regression was employed. An adjusted odds ratio with a 95% confidence interval was used to declare statistically significant variables on the basis of -value<0.05 in the multivariable binary logistic regression model.

RESULTS

Alcohol drinking (adjusted odds ratio (AOR)=3.02, 95% confidence interval (CI)=1.24-7.35), antepartum hemorrhage (AOR=5.74, 95% CI=2.67-12.33), premature rupture of membrane (AOR=2.21, 95% CI=1.09-4.44), meconium-stained amniotic fluid (AOR=8.18, 95% CI=4.29-15.60), non-use of partograph for labor follow-up (AOR=3.89, 95% CI=2.12-7.17), induction of labor (AOR=2.12, 95% CI=1.09-4.11), previous history of stillbirth (AOR=2.15, 95% CI=1.08-4.26), and birthweight less than 2,500 grams (AOR=7.36, 95% CI=3.43-15.81) increase the odds of stillbirth.

CONCLUSION

Stillbirth was higher among women who drank alcohol during their pregnancy, experienced antepartum hemorrhage, premature rupture of membrane, meconium-stained amniotic fluid, induction of labor, labor not followed by partograph, previous history of stillbirth, and birthweight less than 2,500 grams. As such, education to stop alcohol drinking during pregnancy, monitoring the progress of labor with partograph, and improving the quality of care for mothers and newborns at the time of pregnancy and childbirth will contribute to preventing stillbirth.