Stillbirths and associated factors in a peri-urban District in Ghana

Abstract

To determine stillbirth rate and identify causal factors associated with it in the Asante-Akim South district of Ghana. A retrospective review of records of women who had stillbirths at seven Health facilities in the district was conducted. The study period was from January 1, 2010 to December 31, 2012. The maternity registers were used to identify women who gave birth during the study period and data on women with stillbirth collected. The data collected included maternal age, parity, gestation, mode of delivery, obstetric complications, sex and weight of the baby; ante-natal attendance and treatment of malaria in pregnancy, whether the birth was fresh stillbirth or macerated and cause of stillbirth. Births without vital status were excluded. There were 6356 deliveries during the study period with 141 stillbirths giving a stillbirth rate of 22.2 per 1000 births. About 56.7% of the stillbirths were fresh deliveries and 43.3% of them were macerated. More than 60% of the stillbirths were male and about 60.0% of the delivery occurred within 36-41 weeks of gestation. About 50.0% of the women were between the ages of 20-29 with only 18.4% falling within the age bracket of 15-19 years. Unexplained intrauterine foetal death (18.4%), prolong/obstructed labour (14.9%), hypertensive disease (9.9%), and malaria in pregnancy (8.5%) was the leading causes of stillbirth in this study. The prevalence of stillbirth rate among the study subject especially among less educated and younger mothers as well as those engage in petty trading and farming was very high. The major risk factors for stillbirth in this study was unexplained intrauterine feotal death although pre-term birth, low birth weight and hypertensive/diabetic disorders, placenta/cord factors, infections (malaria and HIV) and use of herbs in pregnancy also contributed significantly.Journal of Medical and Biomedical Sciences (2016) 5(1), 23-31Keywords: Stillbirth, preterm birth, intrauterine death, Ghana