Predictors of term stillbirths in an inner-city maternity hospital in Lagos, Nigeria.
OBJECTIVE: To determine the rates, pattern and correlates of term/viable stillbirths (gestational age >or= 37 weeks and fetal weight >or= 2,500 g). DESIGN: Unmatched case-control, cross-sectional study. SETTING: Inner-city maternity hospital, Lagos, Nigeria. METHODS: About two-thirds of all documented stillbirths from 2005 to 2007 were analyzed to determine factors that correlated with viability by comparing term stillbirths first with pre-term stillbirths and then with term live births using multiple logistic regression. MAIN OUTCOME MEASURES: Prevalence rates and adjusted odds ratios at 95% confidence intervals (CIs). RESULTS: Of the total 7,216 deliveries over the three year period, there were 917 qualifying stillbirths out of which 404 (44.1%) were macerated and 13 (1.4%) were identified with congenital anomalies. Over half (57.0%) of the mothers with stillbirths had no antenatal care. Compared with pre-term stillbirths, term stillbirths were significantly associated with multiparity (odds ratio (OR) 0.69; 95% CI 0.48-0.99), antepartum hemorrhage (OR 0.54; 95% CI 0.35-0.83), premature rupture of membranes (OR 0.26; 95% CI 0.14-0.52), hypertensive conditions in pregnancy (OR 0.60; 95% CI 0.39-0.92), cesarean section (OR 1.71: 95% CI 1.13-2.60), cephalopelvic disproportion (OR 3.56; 95% CI 1.43-8.86), prolonged/obstructed labor (OR 1.94; 95% CI 1.22-3.07), and congenital abnormalities (OR 0.20; 95% CI 0.05-0.79). Young maternal age (OR 2.50; 95% CI 1.22-5.14), lack of antenatal care (OR 1.57; 95% CI 1.22-3.07), cord accidents (OR 29.63; 95% CI 14.23-61.71), and fetal distress (OR 5.30; 95% CI 3.35-8.38) emerged as additional risk factors when compared with term live births. CONCLUSIONS: While the uptake of antenatal care was generally poor, most factors associated with the unacceptably high proportion of viable stillbirths in this resource-poor setting were identical to risk factors for total stillbirths and can be effectively managed with improved maternal education and obstetric care.[1]References
- Predictors of term stillbirths in an inner-city maternity hospital in Lagos, Nigeria. Olusanya, B.O., Solanke, O.A. Acta. Obstet. Gynecol. Scand (2009) [Pubmed]
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