Predictors of Intrapartum Stillbirths among Women Delivering at  Mulago Hospital, Kampala, Uganda

Kowal, Paul; Nakimuli, Annettee; Ononge, Samuel; Wandabwa, Julius; Musaba, Milton W.

doi:10.21106/ijma.409

Cited by 7 publications

(5 citation statements)

References 30 publications

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“…In multivariate analysis no statistical link was found ( p = 0.236). This result corroborates that of Sandjong et al in Cameroon ( 8 ). where the risk of stillbirth was high when the patient is referred by another health facility; [OR = 4.81, 95% CI (2.39–9.91); p < 0.001].…”

Section: Discussionsupporting

confidence: 93%

Factors associated with intrapartum stillbirth in a tertiary teaching hospital in Burkina Faso

Komboigo

Zamane

Coulibaly

et al. 2023

Front. Glob. Womens Health

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IntroductionIntrapartum stillbirth is an indicator of health and community development.ObjectiveTo identify the risk factors associated with intrapartum stillbirth in a tertiary teaching hospital in Burkina Faso.Patients and methodsA case-control study conducted from January 1 to August 30, 2019. Cases were defined as patients admitted to Yalgado Ouedraogo teaching hospital (YOTH) with a live fetus of at least 28 weeks’ gestation and who gave birth to an intrapartum stillborn, a fetus delivered without any signs of life in the first minute postpartum. Controls were defined as patients who delivered a live newborn. Study controls were gradually recruited and matched to cases. For each case, two controls were recruited and matched according to criteria such as delivery route and day of delivery. Data were cleaned in Epidata and exported to Stata for analysis. Variables with a p < 0.05 significance level in the multivariable regression were retained. Odds ratio (OR) and 95% confidence intervals are reported.ResultsEighty-three intrapartum stillbirths were documented among a total of 4,122 deliveries, a stillbirth rate of 20.1 per 1,000 births. There was a statistically significant association between intrapartum stillbirth and prior caesarean section (p = 0.045), multiparity (p = 0.03), the receipt of antenatal care (ANC) by a nurse (p = 0.005) and the disuse of the partogram (p = 0.004). We did not find a significant association between the number of ANC consultations performed (p = 0.3), whether membranes were ruptured at admission (p = 0.6), the duration of labor (p = 0.6) and intrapartum fetal death. Multivariate analysis showed that patient referral to another heath facility (OR: 3.33; 95% IC: 1.56, 7.10), no obstetric ultrasound performed (OR: 3.16; 95% IC: 2.11, 4.73), birth weight less than 2,500 g (OR: 7.49; 95% IC: 6.40, 8.76) were significantly associated with intrapartum stillbirth.ConclusionSpecific interventions must be taken to identify these risk factors of intrapartum stillbirth in order to ensure better and appropriate management.

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Section: Discussionsupporting

confidence: 93%

Factors associated with intrapartum stillbirth in a tertiary teaching hospital in Burkina Faso

Komboigo

Zamane

Coulibaly

et al. 2023

Front. Glob. Womens Health

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“…This study showed that, compared to female sex, male sex was more likely to experience stillbirth. This result is consistent with various stillbirth investigations in Nigeria (13), Ghana (40), and Cameroon (18). This result con icts with other studies conducted in Nigeria (24), and Cameroon (18).…”

Section: Discussionsupporting

confidence: 93%

“…In relation to the response rate, the primary articles incorporated in the meta-analysis ranged from 92.7-100%, and essentially all the studies had a good response rate. Forty (40) of the forty-one (41) studies were published (1)-( 30), (32)(33)(34)(35)(36)(37)(38)(39)(40)(41), while one (1) was unpublished (a PhD thesis) in reputable journals (31). Lastly, the primary studies included in the present systematic review and meta-analysis had a quality score of 8-10 out of 10 points.…”

Section: Study Characteristicsmentioning

confidence: 99%

The Factors Associated with Stillbirths among Sub-Saharan African Deliveries: A Systematic review and Meta-analysis

Kasa,

Alemu,

Woldemariam

et al. 2023

Preprint

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Background Globally, more than 2.6 million stillbirths occur each year. The vast majority (98%) of stillbirths occur in low- and middle-income countries, and over fifty percent (55%) of these happen in rural sub-Saharan Africa. Methods Pertinent articles conducted in sub-Saharan Africa were evaluated using a systemic review and meta-analysis approach to determine the factors associated with stillbirths. A literature search was performed using PubMed, the Cochran Library, Google Scholar, EMBASE, Scopus, the Web of Sciences, and gray literature. Rayyan`s software was used for literature screening. A random effects meta-analysis was conducted with STATA version 17. Heterogeneity was checked by using Cochran’s Q and I2 tests. The funnel plots and Egger’s test were used to examine the risk of publication bias. The protocol was sent for registration on January 31, 2023, and the PROSPERO registration number is CRD42023391874. Results Forty-one studies gathered from eight sub-Saharan countries with a total of 192,916 sample sizes were included. Nine variables were highly linked with stillbirth. These include advanced maternal age (AOR: 1.43, 95% CI: 1.16, 1.70), high educational attainment (AOR: 0.55, 95% CI: 0.47, 0.63), antenatal care (AOR: 0.45, 95% CI: 0.35, 0.55), antepartum hemorrhage (AOR: 2.70, 95% CI: 1.91, 3.50), low birth weight (AOR: 1.72, 95% CI: 1.56–1.87), admitted by referal (AOR: 1.55, 95% CI: 1.41, 1.68), history of stillbirth (AOR: 2.43, 95% CI: 1.84, 3.03), anemia (AOR: 2.62, 95% CI: 1.93, 3.31), and hypertension (AOR: 2.22, 95% CI: 1.70, 2.75). Conclusion A significant association was found between stillbirth and maternal age, educational status, antenatal care, antepartum hemorrhage, birth weight, mode of arrival, history of previous stillbirth, anemia, and hypertension. In order to fully screen women, cooperation between experts from many fields should be created beforehand and incorporated into the screening procedure. Keywords: Africa, fetal death, intrauterine fetal death, prenatal death

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“…This is partly due to the hospital being a referral site and most of the deaths are due to conditions that are preventable, such as excessive bleeding, hypertensive disorders of pregnancy (pre-eclampsia/eclampsia), sepsis (bacterial infection) from obstructed labour and abortion-related complications. Serious conditions are compounded by delay in seeking care, delays in getting transport and delays waiting at health facilities (Kiondo et al, 2021;Nakimuli et al, 2016). Most of the women who die, die young, with a mean age of about 26 years, and of these 10 to 15% are adolescents/young adults (< 20 years) (Ministry of Health, 2018).…”

Section: The Imelda Namagembe Study "Implementation Of Maternal Death...mentioning

confidence: 99%

Case studies from the experience of early career researchers in East Africa in building community engagement in research

Bargul¹,

Mkwashapi²,

Namagembe³

et al. 2022

Open Res Africa

Self Cite

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Background: In this paper, we explain how three early career researchers actively engaged community members in their health research projects in Kenya, Tanzania and Uganda, and what was learnt from the experience. The research project in Kenya was on camel trypanosomiasis and the role of camel biting keds (or louse flies) in disease transmission. The project in Tanzania looked at the effect of human immunodeficiency virus and antiretroviral therapy on fertility and ascertained the trends in the use of family planning services amongst women of reproductive age. The focus of the project in Uganda was the implementation of maternal death surveillance and the response policy to determine the cause of maternal deaths and how they might be prevented. Methods: In the three different settings, efforts to ensure local community engagement provided a focus for the researchers to hone their skills in explaining research concepts and working in partnership with community members to co-develop ideas, their research methods and outputs. Results: Involvement of communities in scientific research, which entailed a two-way mutual engagement process, led to (i) generation of new research ideas that shaped the work, (ii) strengthened mutual trust, and (iii) promoted uptake of research findings. Conclusion: Our key findings strongly support the need for considering community engagement as one of the key components in research studies.

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Predictors of Intrapartum Stillbirths among Women Delivering at Mulago Hospital, Kampala, Uganda

Cited by 7 publications

References 30 publications

Factors associated with intrapartum stillbirth in a tertiary teaching hospital in Burkina Faso

Factors associated with intrapartum stillbirth in a tertiary teaching hospital in Burkina Faso

The Factors Associated with Stillbirths among Sub-Saharan African Deliveries: A Systematic review and Meta-analysis

Case studies from the experience of early career researchers in East Africa in building community engagement in research

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