Factors Associated with Stillbirths at Mbarara Regional Referral Hospital

Abstract

Background: Still births contribute more than half 39(65%) to perinatal deaths but can be minimized if pregnancy is adequately monitored during antenatal care and adequate intrapartum care is given. Perinatal mortality is a key outcome indicator for obstetric care, preventable through EMOC and routine antenatal care of a pregnant woman that allows early detection, prompt diagnosis and early treatment of any pregnancy related conditions that improve perinatal outcome. Thus the objective of this study was to determine factors associated with still births among women at Mbarara Regional Referral Hospital in Mbarara District.Methods: An unmatched case control study was adopted. A total of 300 mothers who delivered at or above 28 weeks between august and December 2013 were interviewed using administered questionnaires. Data was analyzed using STATA.Results: We found that 102(34%) mothers had stillbirths and 198(66%) had live births. The mean age (in complete years) of mothers that had live births (25.1±5.45) and those that experienced a stillbirth (25.8±5.89). Mothers in the 30-45 age bracket experienced high 32(31.7%) stillbirth frequency, contrary to younger mothers in the 25-29 age bracket that had the lowest 19(18.8%) stillbirth frequency Therefore, the key determinants of stillbirths at Mbarara Regional Referral Hospital were: obstetric and health systems factors that include (cOR, 95%) inadequate antenatal care: ≤ 3 visits (2.10, 1.12-4.0, P= 0.0312) cord prolapsed (5.8, 1.50-4.28, P=0.012), referral status (3.4, 1.74-6.74, P=0.000), lack of partogram use (6.44, 2.3-7.90, P=0.000) and antenatal booking health facility II (3.9, 1.36-11.26 P=0.000) and anemia (2.75 1.60-6.50 P=0.0213 was the medical factor found to be associated with stillbirth.Conclusions: To significantly lower stillbirth rates at MRRH, there is need to strengthen goal oriented antenatal care so as to identify and address the aforementioned factors during antenatal visits and delivery.

Key words: Stillbirth, Case, Control, Fresh stillbirth (intrapartum stillbirth), Macerated stillbirth (ante partum stillbirth) and Perinatal