Background: Stillbirth is a growing public health issues worldwide and accounts for majority of perinatal death. In resources limited countries, 40% of stillbirth occurs during labor and this loss could be avoided with improved monitoring and timely access to emergency obstetric care when required. The aim of this study was to determine the prevalence of stillbirth and identify its determinants among mothers delivered by cesarean section.
Methods: It was a hospital based retrospective unmatched case control study. Mothers who delivered by cesarean section with the outcome of still birth were cases and three consecutive cesarean section deliveries with live birth were controls. Data were collected using structured data extraction tool developed from literature related to stillbirth and modified according to the local context by the investigators. Variables with p<0.05 in the univariable logistic regression were entered to multivariable logistic regression and declared significant at p<0.05.
Results: A total of 380 sampled chart of mother’s delivered by cesarean section were included in study. Of those, 95 were stillbirth and 285 were live birth. The prevalence of still birth on cesarean section deliveries was 3.3% and 48% of stillbirth and 54% of live birth were in mother’s aged 25 to 34 years. Emergency cesarean section was performed in 93% of stillbirth and 71% of live birth. The major indications for cesarean section were antepartum hemorrhage (37%) for stillbirth and mal-presentation (21%) for live birth. Besides, 70% of stillbirth and 73% of live birth have birth weight of 2500-4000gram. The result showed that emergency cesarean section (AOR: 0.32; 95%CI: 0.14-0.75) and male newborn (AOR: 3.03; 95%CI: 1.78-5.19) were found to have a significant association with stillbirth.
Conclusion: Our study indicates emergency cesarean section for antepartum hemorrhage was associated with increased stillbirth rate. Focusing on causes of antepartum hemorrhage during antenatal care, appropriate intrapartum monitoring and early risk assessment for complications is paramount for early intervention and prevention of still birth.