Mengistu Seble, Debella Adera, Mulatu Teshale, Mesfin Firehiwot, Danusa Kababa Temesgen, Dheresa Merga
Hiwot Fana Specialized University Hospital, College of Health and Medical Science, Haramaya University, Dire Dawa, Ethiopia.
School of Nursing and Midwifery, College of Health and Medical Science, Haramaya University, Dire Dawa, Ethiopia.
Front Pediatr. 2022 May 12;10:820308. doi: 10.3389/fped.2022.820308. eCollection 2022.
Stillbirth, which accounts for half of all the perinatal mortality, is not counted on policy, program, and investment agendas around the globe. It has been underestimated public health burden, particularly in developing countries. Ethiopia is among the top countries with a large prevalence of stillbirth in the world. However, there is a dearth of study on the current magnitude of stillbirth in the study area. Therefore, this study intended to assess the prevalence of stillbirth and its associated factors to bridge the gap.
A hospital-based retrospective study was conducted from 1 to 28 February 2019 and data were collected by reviewing the chart records of all the women who gave birth in the past 2 years (January 2016 to December 2018) at Hiwot Fana Specialized University Hospital. Data were entered into EpiData version 4.2.0.0 software and transported to SPSS version 23 for analysis. Descriptive statistics such as frequency, mean, and SDs were generated. Determinants of stillbirth were analyzed using a binary logistic regression and presented by adjusted odds ratio (AOR) with a 95% CI.
The prevalence of stillbirth was 14.5% (95% CI: 11.7%, 17.6%). Low birth weight (AOR = 2.42, 95% CI: 1.23-4.76), prematurity (AOR = 2.10, 95% CI: 1.10-4.01), premature rupture of membranes (AOR = 2.08, 95% CI: 1.14-3.77), antepartum hemorrhage (AOR = 3.33, 95% CI: 1.66-6.67), obstructed labor (AOR = 2.87, 95% CI: 1.48-5.56), and preeclampsia (AOR = 2.91, 95% CI: 1.28-6.62) were an independently associated with stillbirth.
The prevalence of stillbirth in this study was high. Low birth weight, preterm birth, premature rupture of membranes, antepartum hemorrhage, obstructed labor, and preeclampsia were independently associated with a stillbirth. Therefore, much study is needed involving different stakeholders to reduce stillbirths by improving the health status of women through the provision of quality maternal care including referral systems.
死产占围产期死亡总数的一半，但在全球政策、项目和投资议程中未被纳入考量。其公共卫生负担一直被低估，尤其是在发展中国家。埃塞俄比亚是全球死产发生率较高的国家之一。然而，关于研究地区当前死产规模的研究匮乏。因此，本研究旨在评估死产发生率及其相关因素，以填补这一空白。
于2019年2月1日至28日开展了一项基于医院的回顾性研究，通过查阅希沃特·法纳专科医院过去两年（2016年1月至2018年12月）所有分娩妇女的病历记录来收集数据。数据录入EpiData 4.2.0.0软件，并传输至SPSS 23版本进行分析。生成了诸如频数、均值和标准差等描述性统计数据。使用二元逻辑回归分析死产的决定因素，并以调整比值比（AOR）及95%置信区间呈现。
死产发生率为14.5%（95%置信区间：11.7%，17.6%）。低出生体重（AOR = 2.42，95%置信区间：1.23 - 4.76）、早产（AOR = 2.10，95%置信区间：1.10 - 4.01）、胎膜早破（AOR = 2.08，95%置信区间：1.14 - 3.77）、产前出血（AOR = 3.33，95%置信区间：1.66 - 6.67）、产程梗阻（AOR = 2.87，95%置信区间：1.48 - 5.56）和子痫前期（AOR = 2.91，95%置信区间：1.28 - 6.62）均与死产独立相关。
本研究中死产发生率较高。低出生体重、早产、胎膜早破、产前出血、产程梗阻和子痫前期均与死产独立相关。因此，需要众多利益相关者参与开展更多研究，通过提供包括转诊系统在内的优质孕产妇护理来改善妇女健康状况，从而降低死产率。
