https://orcid.org/0000-0001-8051-7779
Abstract
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 p-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.
Abbreviations
ANC, antenatal care; AOR, adjusted odds ratio; APH, A\ante partum hemorrhage; CI, confidence interval; COR, crude odds ratio; DM, diabetes mellitus; EDHS, Ethiopian Demographic Health Survey; HDP, hypertensive disorder of pregnancy; HIV, human immunodeficiency virus; LBW, low birthweight; OR, odds ratio; PROM, premature rupture of membrane; SPSS, Statistical Package for the Social Sciences; WHO, World Health Organization.
Data Sharing Statement
The dataset analyzed during the current study is available from the corresponding author on reasonable request.
Ethics Approval and Consent to Participate
Ethical clearance and approval was obtained from the Institutional Review Board (IRB) of the University of Gondar. A letter of cooperation was obtained from the school of Midwifery department of Women’s and Family health and submitted to the hospital chief executive officers (CEO). The purpose of the study was explained to the study participants and verbal informed consent was obtained from each of the study participants. Verbal informed consent was approved by the Institutional Review Board of University of Gondar, and this study was conducted in accordance with the Declaration of Helsinki. Reassurance was given for those cases before data collection. No personal identifiers were included in the datasheet and the data taken from the participants were kept confidential and used only for the study purposes.
Acknowledgments
We are highly indebted to Amhara regional state health bureau for permitting us to conduct the study and providing the necessary preliminary information while conducting this study. We would also like to extend our appreciation to the study participants, supervisors, and data collectors.
Author Contributions
All authors contributed to the data analysis, drafting or revising the article, have agreed on the journal to which the article will be submitted, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.
Disclosure
The authors have declared that they have no conflicts of interest for this work.