Burden and determinants of stillbirth in a Nigerian Tertiary health facility: a five-year retrospective cohort analysis
摘要
Stillbirth rates can reflect the quality of a country’s healthcare system for pregnant women. The burden, however, differs across and within countries. Hence, determining the burden and associated factors could provide valuable location-specific insights that could guide interventions.
ObjectivesTo determine the incidence and correlates of stillbirth in a Nigerian Tertiary health facility.
MethodsThis was a retrospective study of women who delivered in the Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria, between 1st January 2016 and 31st December 2020. Data for the women were extracted from medical records, including sociodemographic data, time of delivery, mode of delivery, and perinatal outcomes. Regression analysis was used to identify predictors of stillbirth.
ResultsThe overall stillbirth rate was 88.30 per 1,000 births (1,033/11,699 per 1,000 births), while the rates from 2016 to 2020 were 93.65, 96.25, 90.98, 82.84, and 80.72, respectively. Multiple gestations are associated with a 2.22-fold higher risk of stillbirth compared to single gestations (AOR: 0.45, 95% CI: 0.30–0.67). Primiparous women were 2.63 times at risk of delivering stillbirths compared to multiparous women (AOR: 0.38, 95% CI: 0.30–0.47) and 1.75 times the risk compared to grand multiparous women (AOR: 0.57, 95% CI: 0.47–0.68). Furthermore, unbooked pregnancy and prematurity were associated with 3.47 (AOR 3.47, 95% CI: 2.99–4.07) and 9.60 (AOR 9.62, 95% CI: 7.99–11.57) times increased odds of stillbirths. Maternal employment status and maternal age showed no significant association with the risk of stillbirth.
ConclusionsThe stillbirth rate is high and calls for comprehensive intervention. Strengthening antenatal and perinatal care for high-risk groups, including women with multiple gestations, unbooked pregnancies, and premature deliveries, is essential.