Determinants of stillbirth in hospitals of North Shoa Zone, Oromia region, Central Ethiopia: A case control study

Gizaw, Workineh; Feyisa, Mulugeta; Hailu, Dejene; Nigussie, Tadesse

doi:10.1016/j.heliyon.2021.e07070

Cited by 8 publications

(5 citation statements)

References 27 publications

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“…This study also revealed that induced labor onset was also a significant factor associated with an increased risk of stillbirth. This finding is supported by a previous study [ 31 ]. The possible explanation for this association is that when labor is induced, the fetus may be exposed to stressful uterine contractions, which can ultimately lead to fetal demise [ 34 ].…”

Section: Discussionsupporting

confidence: 92%

“…In addition, this study identified that women with a labor duration of 24 hours or longer were 3.80 times more likely to experience stillbirth. This finding aligns with the results of various studies conducted in Ethiopia [ 31 – 33 ], which consistently reported prolonged labor as a significant risk factor for stillbirth. The prolonged labor may result in fetal distress, leading to intrauterine fetal death.…”

Section: Discussionsupporting

confidence: 91%

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Determinants of stillbirth among women who delivered in hospitals of North Wollo Zone, Northeast Ethiopia: A case-control study

Abriham,

Shitie,

Melese

et al. 2024

PLoS ONE

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Background Stillbirth is a silent tragedy that shatters the lives of women, families, and nations. Though affecting over 2 million infants globally in 2019, it remains overlooked, with no specific targets dedicated to its reduction in the sustainable development goals. Insufficient knowledge regarding the primary risk factors contributing to stillbirths hinders efforts to reduce its occurrence. Driven by this urgency, this study focused on identifying the determinants of stillbirth among women giving birth in hospitals across North Wollo Zone, Northeast Ethiopia. Methodology This study employed an institution-based unmatched case-control design, involving a randomly selected sample of 412 women (103 cases and 309 controls) who gave birth in hospitals of North Wollo Zone. Data were collected using a structured data extraction checklist. Data entry was conducted using Epi-data version 3.1, and analysis was performed using SPSS version 25.0. Employing a multivariable logistic regression model, we identified independent predictors of stillbirth. The level of statistical significance was declared at a p-value < 0.05. Results Our analysis revealed several critical factors associated with an increased risk of stillbirth. Women who experienced premature rupture of membranes (AOR = 5.53, 95% CI: 2.33–9.94), induced labor (AOR = 2.24, 95% CI: 1.24–4.07), prolonged labor exceeding 24 hours (AOR = 3.80, 95% CI: 1.94–7.45), absence of partograph monitoring during labor (AOR = 2.45, 95% CI: 1.41–4.26) were all significantly associated with increased risk of stillbirth. Preterm birth (AOR = 3.46, 95% CI: 1.87–6.39), post-term birth (AOR = 3.47, 95% CI: 1.35–8.91), and carrying a female fetus (AOR = 1.81, 95% CI: 1.02–3.22) were at a higher risk of stillbirth. Conclusion These findings highlight the importance of early intervention and close monitoring for women experiencing premature rupture of membranes, prolonged labor, or induced labor. Additionally, consistent partograph use and enhanced prenatal care for pregnancies at risk of preterm or post-term birth could potentially contribute to reducing stillbirth rates and improving maternal and neonatal outcomes. Further research is needed to investigate the underlying mechanisms behind the observed association between fetal sex and stillbirth risk.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 91%

Determinants of stillbirth among women who delivered in hospitals of North Wollo Zone, Northeast Ethiopia: A case-control study

Abriham,

Shitie,

Melese

et al. 2024

PLoS ONE

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“…The study has also revealed that congenital malformations, deformations, and chromosomal abnormalities were associated with stillbirth outcomes, i.e., there is a threefold higher risk of stillbirth among perinate with congenital abnormalities than their counterparts. This finding was consistent with studies conducted in Ethiopia ( 71 ), Cameroon ( 28 ), and India ( 26 ). This could be due to a lack of maturity of the vital organs for fetal survival making the fetus prone to fatal complications and death.…”

Section: Discussionsupporting

confidence: 92%

Determinants of stillbirth among reviewed perinatal deaths in Ethiopia

et al. 2022

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BackgroundThe global burden of stillbirth has declined over time. However, the problem is still prominent in South Asian and Sub-Saharan African countries. Ethiopia is one of the top stillbirth-reporting countries worldwide. Despite several measures taken to reduce the burden of stillbirth; the pace of decline was not as good as the post-neonatal death. Thus, this study is aimed at identifying potential factors related to stillbirth in Ethiopia based on nationally reviewed perinatal deathsMethodThe national perinatal death surveillance data were used for this study. A total of 3,814 reviewed perinatal death were included in the study. Two model families,namely generalized estimating equation, and alternating logistic regression models from marginal model family were employed to investigate the risk factors of stillbirth. The alternating logistic regression model was selected as the best fit for the final analysis.ResultAmong reviewed perinatal deaths nearly forty percent (37.4%) were stillbirths. The findings from the multivariate analysis demonstrated that the place of birth (in transit and at home), cause of death (infection, and congenital and chromosomal abnormalities), maternal health condition (women with complications of pregnancy, placenta, and cord), delay one (delay in deciding to seek care) and delay three (delay in receiving adequate care) were associated with an increased risk of having a stillbirth. On the other hand, maternal education (women with primary and above education level) and the type of health facility (women who were treated in secondary and tertiary health care) were associated with a decreased risk of having a stillbirth.ConclusionThe study identified that both individual (place of delivery, cause of death, maternal health condition, maternal education, and delay one) and facility level (type of health facility and delay three) factors contributed to stillbirth outcome. Therefore, policies that are aimed at encouraging institutional delivery, improving health seeking behavior, and strengthening facility-level readiness should be devised to reduce the high burden of stillbirth in Ethiopia.

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“…Congenital malformations, deformations, and chromosomal abnormalities were also positively related to the three-timing of perinatal deaths. The finding was coherent with studies conducted in Ethiopia (Bahardar and North Shewa) [ 71 , 106 ] Cameroon [ 107 ], India [ 33 ], and Jordan [ 108 ]. This could be explained by the organ dysfunction as well as the lack of vital organs used for the survival of the fetus making them more vulnerable to fatal complications.…”

Section: Discussionsupporting

confidence: 87%

Timing of perinatal death; causes, circumstances, and regional variations among reviewed deaths in Ethiopia

et al. 2023

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Introduction Ethiopia is one of the countries facing a very high burden of perinatal death in the world. Despite taking several measures to reduce the burden of stillbirth, the pace of decline was not that satisfactory. Although limited perinatal mortality studies were conducted at a national level, none of the studies stressed the timing of perinatal death. Thus, this study is aimed at determining the magnitude and risk factors that are associated with the timing of perinatal death in Ethiopia. Methods National perinatal death surveillance data were used in the study. A total of 3814 reviewed perinatal deaths were included in the study. Multilevel multinomial analysis was employed to examine factors associated with the timing of perinatal death in Ethiopia. The final model was reported through the adjusted relative risk ratio with its 95% Confidence Interval, and variables with a p-value less than 0.05 were declared statistically significant predictors of the timing of perinatal death. Finally, a multi-group analysis was carried out to observe inter-regional variation among selected predictors. Result Among the reviewed perinatal deaths, 62.8% occurred during the neonatal period followed by intrapartum stillbirth, unknown time of stillbirth, and antepartum stillbirth, each contributing 17.5%,14.3%, and 5.4% of perinatal deaths, respectively. Maternal age, place of delivery, maternal health condition, antennal visit, maternal education, cause of death (infection and congenital and chromosomal abnormalities), and delay to decide to seek care were individual-level factors significantly associated with the timing of perinatal death. While delay reaching a health facility, delay to receive optimal care health facility, type of health facility and type region were provincial-level factors correlated with the timing of perinatal death. A statistically significant inter-regional variation was observed due to infection and congenital anomalies in determining the timing of perinatal death Conclusion Six out of ten perinatal deaths occurred during the neonatal period, and the timing of perinatal death was determined by neonatal, maternal, and facility factors. As a way forward, a concerted effort is needed to improve the community awareness of institutional delivery and ANC visit. Moreover, strengthening the facility level readiness in availing quality service through all paths of the continuum of care with special attention to the lower-level facilities and selected poor-performing regions is mandatory.

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Determinants of stillbirth in hospitals of North Shoa Zone, Oromia region, Central Ethiopia: A case control study

Cited by 8 publications

References 27 publications

Determinants of stillbirth among women who delivered in hospitals of North Wollo Zone, Northeast Ethiopia: A case-control study

Determinants of stillbirth among women who delivered in hospitals of North Wollo Zone, Northeast Ethiopia: A case-control study

Determinants of stillbirth among reviewed perinatal deaths in Ethiopia

Timing of perinatal death; causes, circumstances, and regional variations among reviewed deaths in Ethiopia

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