Liyew Atrsaw Dessie, Molla Mihretu, Azene Zelalem Nigussie
Department of Midwifery, College of Health Sciences, Dessie, Ethiopia.
Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Int J Womens Health. 2021 Jun 11;13:557-567. doi: 10.2147/IJWH.S305786. eCollection 2021.
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.
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.
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.
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.
全球范围内，每年有260万例死产发生，其中超过四分之三记录在南亚和撒哈拉以南非洲。因此，本研究的目的是确定2019年在埃塞俄比亚西北部和中北部的阿姆哈拉地区转诊医院分娩的妇女中死产的风险因素。
在2019年10月1日至12月30日期间在阿姆哈拉地区转诊医院分娩的456名母亲中进行了一项多中心基于机构的非匹配病例对照研究。分别采用连续和简单随机抽样方法选择病例和对照。使用半结构化、由访谈员管理的问卷和患者病历审查来收集数据。分别使用Epidemiological（Epi）数据版本4.4.2.1和社会科学统计软件包（SPSS）版本25.0进行数据录入和分析。采用二元逻辑回归。在多变量二元逻辑回归模型中，基于P值<0.05，使用调整后的优势比和95%置信区间来确定具有统计学意义的变量。
饮酒（调整后的优势比（AOR）=3.02，95%置信区间（CI）=1.24 - 7.35）、产前出血（AOR = 5.74，95% CI = 2.67 - 12.33）、胎膜早破（AOR = 2.21，95% CI = 1.09 - 4.44）、羊水粪染（AOR = 8.18，95% CI = 4.29 - 15.60）、未使用产程图进行产程监测（AOR = 3.89，95% CI = 2.12 - 7.17）、引产（AOR = 2.12，95% CI = 1.09 - 4.11）以及死产史（AOR = 2.15，95% CI = 1.08 - 4.26）和出生体重低于2500克（AOR = 7.36，95% CI = 3.43 - 15.81）会增加死产几率。
孕期饮酒、经历产前出血、胎膜早破、羊水粪染、引产、未使用产程图监测产程、有死产史以及出生体重低于2500克这些情况的妇女死产率更高。因此，开展孕期戒酒教育、使用产程图监测产程进展以及提高孕期和分娩时对母亲和新生儿的护理质量将有助于预防死产。
