Melaku Ayal Gizachew, Messelu Mengistu Abebe, Alemayehu Mulunesh, Akalu Tadesse Yirga, Kerebeh Gashaw, Dessalegn Roza Belayneh, Agazhe Moges
Finote Selam General Hospital, Finote Selam, Ethiopia.
Department of Nursing, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
Matern Health Neonatol Perinatol. 2025 Apr 1;11(1):7. doi: 10.1186/s40748-024-00199-z.
Stillbirth is still a major public health problem in middle- and low-income countries. However, there has been limited research conducted to identify determinants of stillbirth in Ethiopia. Therefore, this study aimed to identify the determinants of stillbirth among women who gave birth in public hospitals in the West Gojjam Zone, Northwest Ethiopia.
An unmatched case-control study was conducted among 418 mothers who gave birth from March 1-30, 2022. Consecutive and systematic sampling techniques were used to select the cases and controls, respectively. The collected data were entered into Epidata and exported into SPSS version 16 for analysis. Numerical descriptive statistics were expressed by using the mean with standard deviation (SD) and/or median with interquartile range (IQR), whereas categorical variables were expressed by proportions. Bivariable and multivariable binary logistic regression analyses were used to identify determinants of stillbirth. The model goodness of fit test was checked using the Hosmer-Lemeshow test. Variables having a P-value ≤ 0.25 in the bivariable analysis were entered into the multivariable analysis model. Adjusted odds ratio with 95% confidence intervals (CIs) was used to report the strength of association, and variables with a P-value < 0.05 were considered statistically significant.
A total of 105 cases and 313 controls were included in this study. The odds of having stillbirth were higher among women who were illiterate (AOR: 1.6, 95% CI: 1.34, 7.55), had first ANC visit in the second trimester (AOR: 11.4, 95% CI: 2.99, 43.71), had an induced mode of delivery (AOR: 8.7, 95% CI: 2.10, 36.03), history of stillbirth (AOR: 1.5, 95% CI: 1.45, 4.90), bad obstetric history (AOR: 4.8, 95% CI: 1.44, 15.89), history of preterm (AOR: 7.6, 95% CI: 1.57, 37.21), not vaccinated for TT (AOR: 8.8, 95% CI: 2.23, 35.17), labor not followed by using partograph (AOR: 3.1, 95% CI: 1.10, 8.42), and history of abortion (AOR: 11, 95% CI: 2.91, 41.31).
The determinants of stillbirth included women who were illiterate, started ANC visits in the second trimester, had an induced mode of delivery, history of stillbirth, bad obstetric history, history of preterm, history of abortion, not vaccinated for TT, and not followed by partograph. It is better to improve partograph utilization during intrapartum care and screen mothers who had a higher risk of adverse birth outcomes during their pregnancy to avert the problem.
死产在中低收入国家仍然是一个重大的公共卫生问题。然而，在埃塞俄比亚，针对确定死产决定因素的研究有限。因此，本研究旨在确定埃塞俄比亚西北部戈贾姆西区公立医院分娩的妇女中死产的决定因素。
对2022年3月1日至30日分娩的418名母亲进行了一项非匹配病例对照研究。分别采用连续和系统抽样技术选择病例和对照。收集的数据录入Epidata，并导出到SPSS 16版进行分析。数值描述性统计用均值加标准差（SD）和/或中位数加四分位数间距（IQR）表示，分类变量用比例表示。采用双变量和多变量二元逻辑回归分析来确定死产的决定因素。使用Hosmer-Lemeshow检验检查模型拟合优度。在双变量分析中P值≤0.25的变量被纳入多变量分析模型。用95%置信区间（CI）的调整比值比来报告关联强度，P值<0.05的变量被认为具有统计学意义。
本研究共纳入105例病例和313例对照。文盲妇女发生死产的几率更高（调整后比值比：1.6，95%置信区间：1.34，7.55），妊娠中期首次进行产前检查（调整后比值比：11.4，95%置信区间：2.99，43.71），采用引产方式分娩（调整后比值比：8.7，95%置信区间：2.10，36.03），有死产史（调整后比值比：1.5，95%置信区间：1.45，4.90），不良产科史（调整后比值比：4.8，95%置信区间：1.44，15.89），早产史（调整后比值比：7.6，95%置信区间：1.57，37.21），未接种破伤风类毒素（调整后比值比：8.8，95%置信区间：2.23，35.17），分娩时未使用产程图（调整后比值比：3.1，95%置信区间：1.10，8.42），以及流产史（调整后比值比：11，95%置信区间：2.91，41.31）。
死产的决定因素包括文盲妇女、妊娠中期开始产前检查、采用引产方式分娩、有死产史、不良产科史、早产史、流产史、未接种破伤风类毒素以及未使用产程图。最好在产时护理期间提高产程图的使用率，并在孕期筛查有不良分娩结局高风险的母亲，以避免这一问题。
