Regassa Yeshi, Lemi Hunde, Charkos Tesfaye Getachew
School of Public Health, Adama Hospital Medical College, Adama, Ethiopia.
Front Glob Womens Health. 2024 Dec 6;5:1441636. doi: 10.3389/fgwh.2024.1441636. eCollection 2024.
Stillbirth remains a major public health problem in developing countries due to low health coverage and services. Approximately two million stillbirths occur every year; in particular, stillbirths are highly prevalent in low- and middle-income countries such as Ethiopia. However, there is scarce information available in Ethiopia regarding the determinants of stillbirth.
A facility-based, unmatched case-control study was conducted at Bishoftu General Hospital from April 1 to April 30, 2023. A systematic random sampling technique was used to select samples of the study subjects. The collected data were entered into Epi-info version 7.2. A Bayesian logistic regression model was used in this study, with a 95% Credible interval to determine the association between independent variables and stillbirth. All analyses were performed using STATA version 17 software.
A total of 403 (81 cases and 322 controls) participants were included in the study. The average age of participants was 26 years (SD: ±5.03). According to the adjusted model, mothers who attained a middle school [adjusted odds ratio [AOR] = 0.23; 95% credible interval [CrI]: 0.11, 0.43], diploma and above (AOR = 0.25; 95% CrI: 0.12, 0.46), rural residence (AOR = 2.55; 95% CrI: 1.11, 4.99), married women (AOR = 0.46; 95% CrI: 0.20, 0.93), ANC visits more than 4 (AOR = 0.35; 95% CrI: 0.17, 0.63), history of prior stillbirth (AOR = 8.71; 95% CI: 3.22, 17.69), previous history of abortion (AOR = 3.29; 95% CI: 1.13, 7.666), duration of labor more than 24 h (AOR = 3.71; 95% CI: 1.28, 7.83); normal birth weight (AOR = 0.39; 95% CI: 0.15, 0.57) were significantly associated with stillbirth.
This study revealed that maternal education, rural residence, marital status, history of prior stillbirth, ANC visit, previous history of abortion, duration of labor, and birth weight were identified as determinants of stillbirth. Pregnant mothers should be identified early and given appropriate care, including comprehensive prenatal care and other maternal services.
由于卫生保健覆盖范围和服务水平较低，死产在发展中国家仍然是一个重大的公共卫生问题。每年约有200万例死产发生；特别是在埃塞俄比亚等低收入和中等收入国家，死产现象极为普遍。然而，埃塞俄比亚关于死产决定因素的信息却非常匮乏。
2023年4月1日至4月30日，在比绍夫图综合医院开展了一项基于机构的非匹配病例对照研究。采用系统随机抽样技术选取研究对象样本。收集的数据录入Epi-info 7.2版本。本研究使用贝叶斯逻辑回归模型，以95%可信区间确定自变量与死产之间的关联。所有分析均使用STATA 17软件进行。
共有403名参与者（81例病例和322例对照）纳入研究。参与者的平均年龄为26岁（标准差：±5.03）。根据调整后的模型，达到中学学历的母亲[调整后的优势比[AOR]=0.23；95%可信区间[CrI]：0.11，0.43]、大专及以上学历（AOR=0.25；95% CrI：0.12，0.46）、农村居民（AOR=2.55；95% CrI：1.11，4.99）、已婚妇女（AOR=0.46；95% CrI：0.20，0.93）、产前检查次数超过4次（AOR=0.35；95% CrI：0.17，0.63）、有死产史（AOR=8.71；95%可信区间[CI]：3.22，17.69）、有流产史（AOR=3.29；95% CI：1.13，7.666）、产程超过24小时（AOR=3.71；95% CI：1.28，7.83）；正常出生体重（AOR=0.39；95% CI：0.15，0.57）与死产显著相关。
本研究表明，母亲教育程度、农村居民身份、婚姻状况、既往死产史、产前检查、既往流产史、产程和出生体重被确定为死产的决定因素。应尽早识别怀孕母亲并给予适当护理，包括全面的产前护理和其他孕产妇服务。
