Dataset Information

Predictors of stillbirth among women who had given birth in Southern Ethiopia, 2020: A case-control study.

ABSTRACT:

Background

Although the rate of stillbirth has decreased globally, it remains unacceptably high in low- and middle-income countries. Only ten countries including Ethiopia attribute more than 65% of global burden of still birth. Ethiopia has the 7th highest still birth rate in the world. Identifying the predictors of stillbirth is critical for developing successful interventions and monitoring public health programs. Although certain studies have assessed the predictors of stillbirth, they failed in identify the proximate predictors of stillbirth. In addition, the inconsistent findings in identify the predictors of stillbirth, and the methodological limitations in previously published works are some of the gaps. Therefore, this study aimed to identify the predictors of stillbirth among mothers who gave birth in six referral hospitals in Southern, Ethiopia.

Methods

A hospital-based unmatched case-control study was conducted in six referral hospitals in Southern, Ethiopia from October 2019 to June 2020. Consecutive sampling techniques and simple random techniques were used to recruit cases and controls respectively. A structured standard tool was used to identify the predictors of stillbirth. Data were entered into Epi Info 7 and exported to SPSS 23 for analysis. A multivariable logistic regression model was used to identify the independent predictors of stillbirth. The goodness of fit was tested using the Hosmer and Lemeshow goodness-of-fit. In this study P-value < 0.05 was considered to declare a result as a statistically significant association.

Results

In this study 138 stillbirth cases and 269 controls were included. Women with multiple pregnancy [AOR = 2.98, 95%CI: 1.39-6.36], having preterm birth [AOR = 2.83, 95%CI: 1.58-508], having cesarean mode of delivery [AOR = 3.19, 95%CI: 1.87-5.44], having no ANC visit [AOR = 4.17, 95%CI: 2.38-7.33], and being hypertensive during pregnancy [AOR = 3.43, 95%CI: 1.93-6.06] were significantly associated with stillbirth.

Conclusions

The predictors of stillbirth identified are manageable and can be amenable to interventions. Therefore, strengthening maternal antenatal care utilization should be encouraged by providing appropriate information to the mothers. There is a need to identify, screen, and critically follow high-risk mothers: those who have different complications during pregnancy, and those undergoing cesarean section due to different indications.

SUBMITTER: Abebe H

PROVIDER: S-EPMC8092801 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundEarly neonatal death caused by preterm birth contributes the most for perinatal death. The prevalence of preterm birth continues to rise and is a significant public health problem. The exact cause of preterm birth is yet unanswered, as mostly preterm birth happens spontaneously. Predictors of preterm birth in developing countries like Ethiopia were not well investigated, and no study was conducted before this in the study area.ObjectivesTo identify predictors of preterm birth in Western Ethiopia, 2017/2018.MethodsHealth facility-based unmatched case-control study was conducted from October 20/2017-march 20/2018 in 4 Hospitals. A total sample size of 358 women was recruited. From this 72 were cases and 286 were controls. Cases were mothers who gave Preterm birth, and controls were mothers who gave birth at term. Ethical clearance was obtained from Wollega University ethical review committee. A pre tested, structured questionnaire was used to collect data. Data entry and analysis was done using Epi Data 3.1 and SPSS version 21, respectively. Logistic regression was done to identify predictors of preterm birth.ResultThree hundred fifty-eight women participated in this study of which 72 were cases and 286 were controls; making the overall response rate of 100%. Lack of antenatal care visit [AOR = 3.18, 95% CI 1.37-7.38]),(Having 1-2 antenatal care visit [AOR = 2.27, 95% CI 1.18-4.35]),history of previous preterm)[AOR = 5.19, 95% CI1.29-20.88],Short Interpregnancy Interval [AOR = 4.41.95% CI 2.05-9.47],Having Reproductive tract infections [AOR = 2.54, 95% CI 1.02-6.32] and having Obstetric complications [AOR = 2.48,95% CI 1.31-4.71] were found to be predictors of preterm birth.Conclusion and recommendationRisk factors of preterm delivery are multifactorial and depend on geographical and demographic features of the population studied. Hence results of studies from one area might not be applicable to another area. Antenatal care visits are unique opportunities for early diagnosis and treatment of problems. Therefore, antenatal care should be strengthened, and appropriate counseling should be given at each antenatal care follow up. Maintainning optimum birth interval through family planning, and early identification and treatment of reproductive tract infections are mandatory.

Project description:BackgroundWorldwide, preterm birth accounts for 1 million deaths of infants each year and 60% of these deaths occur in developing countries. In addition to the significant health consequences on the infant, preterm birth can lead to economic costs. There was a lack of study in western Ethiopia, and most of those studies conducted in other parts of a country were based on card review with a cross-sectional study design. The risk factors of preterm birth may vary from region to region within the same country due to variation in socioeconomic status and health care service coverage. Therefore, this study aimed to identify determinants of preterm birth in western Ethiopia.MethodsAn institutional-based case-control study was conducted from February 15 to April 15, 2020, in western Ethiopia. The eligible 188 cases and 377 controls were randomly selected for this study. Cases were women who gave birth after 28 weeks and before 37 completed weeks of gestation, and controls were women who gave birth at and after 37 weeks of gestation from the first day of the last normal menstrual period. Data were collected by a structured interviewer-administered questionnaire. The collected data were entered into Epi info version 7 and exported to SPSS version 21 for analysis. Multivariable logistic regression was used to identify determinants of preterm birth at P-value <0.05.ResultsFrom a total of 565 eligible participants, 516 (172 cases and 344 controls) participated in this study with a response rate of 91.3%. The result of the multivariable analysis shows that mothers who developed pregnancy-induced hypertension (AOR = 3.13, 95% CI; 1.78, 5.50), only one time ANC visits (AOR = 5.99, 95% CI; 2.65, 13.53), experienced premature rupture of membrane (AOR = 3.57, 95% CI; 1.79, 7.13), birth interval less than two years (AOR = 2.96, 95% CI; 1.76, 4.98), developed anemia during the current pregnancy (AOR = 4.20, 95% CI; 2.13, 8.28) and didn't get dietary supplementation during the current pregnancy (AOR = 2.43, 95% CI; 1.51, 3.91) had statistically significant association with experiencing preterm birth.ConclusionAntenatal care service providers should focus on mothers with pregnancy-induced hypertension, premature rupture of membrane, and anemia during pregnancy, and refer to the senior experts for early management to reduce the risk of preterm delivery. Antenatal care services such as counseling the mother on the benefit of dietary supplementation during pregnancy, antenatal care follow up, and lengthening birth interval should be integrated into the existing health extension packages. New and inclusive strategies such as the establishment of comprehensive mobile clinic services should also be designed to reduce the burden of preterm birth among women living in the rural community. Lastly, we recommend future researchers to conduct longitudinal and community-based studies supplemented with qualitative methods.

Project description:BackgroundStillbirth is a silent tragedy that shatters the lives of women, families, and nations. Though affecting over 2 million infants globally in 2019, it remains overlooked, with no specific targets dedicated to its reduction in the sustainable development goals. Insufficient knowledge regarding the primary risk factors contributing to stillbirths hinders efforts to reduce its occurrence. Driven by this urgency, this study focused on identifying the determinants of stillbirth among women giving birth in hospitals across North Wollo Zone, Northeast Ethiopia.MethodologyThis study employed an institution-based unmatched case-control design, involving a randomly selected sample of 412 women (103 cases and 309 controls) who gave birth in hospitals of North Wollo Zone. Data were collected using a structured data extraction checklist. Data entry was conducted using Epi-data version 3.1, and analysis was performed using SPSS version 25.0. Employing a multivariable logistic regression model, we identified independent predictors of stillbirth. The level of statistical significance was declared at a p-value < 0.05.ResultsOur analysis revealed several critical factors associated with an increased risk of stillbirth. Women who experienced premature rupture of membranes (AOR = 5.53, 95% CI: 2.33-9.94), induced labor (AOR = 2.24, 95% CI: 1.24-4.07), prolonged labor exceeding 24 hours (AOR = 3.80, 95% CI: 1.94-7.45), absence of partograph monitoring during labor (AOR = 2.45, 95% CI: 1.41-4.26) were all significantly associated with increased risk of stillbirth. Preterm birth (AOR = 3.46, 95% CI: 1.87-6.39), post-term birth (AOR = 3.47, 95% CI: 1.35-8.91), and carrying a female fetus (AOR = 1.81, 95% CI: 1.02-3.22) were at a higher risk of stillbirth.ConclusionThese findings highlight the importance of early intervention and close monitoring for women experiencing premature rupture of membranes, prolonged labor, or induced labor. Additionally, consistent partograph use and enhanced prenatal care for pregnancies at risk of preterm or post-term birth could potentially contribute to reducing stillbirth rates and improving maternal and neonatal outcomes. Further research is needed to investigate the underlying mechanisms behind the observed association between fetal sex and stillbirth risk.

Project description:BackgroundA maternal near-miss (MNM) refers to when a gravely ill woman survives a complication as a result of the standard of care she receives or by chance during gestation, childbirth, or within 42 days of the termination of pregnancy. Rescuers of near-miss events share several features with mothers who have died and identifying MNM determinants will aid in improving the capacity of the health system to reduce severe maternal morbidity and mortality. Ethiopia is one of the countries in sub-Saharan Africa with high maternal mortality and morbidity, but there is little evidence on determinants of a MNM based on a WHO criteria. Hence, this study aimed at identifying determinants of MNM among women admitted to tertiary hospitals in southern Ethiopia, 2020.MethodsA facilities-based unmatched case-control study was conducted in five selected tertiary hospitals found in central southern Ethiopia from February 1 to June 1, 2020. A total of 322 (81 cases and 241 controls) study participants were included in the study. At the time of their discharge, cases were recruited consecutively, while controls were selected using a systematic sampling method. The cases were women admitted to hospitals during pregnancy, childbirth, or 42 days following termination of pregnancy who met at least one of the WHO near-miss criteria. Whereas the controls comprised of women who were admitted during pregnancy, childbirth, or 42 days following termination of pregnancy and discharged without severe obstetric complications. Data collection was conducted using the interviewer-administered structured questionnaire and data abstraction tool. The data was coded and entered into Epi-Data version 3.1 and exported to SPSS version 23 for analysis. Multivariable logistic regression analysis was conducted and determinants of MNM were established at p-value<0.05.ResultsSevere postpartum hemorrhage (50.6%) and sepsis (23.4%) were the most common reasons for admission of cases. Lack of ANC [AOR = 3.25; 95%CI: 2.21,7.69], prior history of Cesarean section [AOR = 3.53; 95%CI:1.79,6.98], delaying more than 60 minute to access final place of care [AOR = 3.21; 95%CI:1.61,6.39], poor practice of Birth preparedness and complication readiness (BPCR) [AOR = 3.31; 95%CI:1.50,7.29], and history of preexisting medical disorders [AOR = 2.79; 95%CI:1.45,5.37] were identified as significantly determinants of maternal near miss.Conclusion and recommendationStakeholders need to enhance their efforts for improving access to roads and transportations. Besides, women who have a prior history of Caesarean section, chronic medical conditions, and no ANC need special attention from their families and health care providers to proactively mitigate the occurrence of serious obstetric complications. More attention has to be paid to birth preparedness and complication readiness activities.

Project description:BackgroundPreterm birth is defined as the birth of a baby before 37 completed weeks of gestation. Worldwide, prematurity is the second foremost cause of death in children under the age of 5 years. Preterm birth also gives rise to short and long term complications. Therefore, the primary aim of this study was to identify the factors associated with preterm birth in Wachemo University Nigist Eleni Mohammed Memorial referral hospital, Hadiya Zone, Southern Ethiopia.MethodsAn institution-based unmatched case-control study was conducted from July 01, 2018 to June 30, 2019 among mothers who gave birth in Wachemo University Nigest Eleni Mohammed Memorial referral hospital. A retrospective one-year data was retrieved from medical records of mothers with their index neonates. Simple random sampling technique was employed to recruit study participants. SPSS version 20 software was used for data entry and computing statistical analysis. Both bivariable and multivariable logistic regression analyses were used to determine the association of each independent variable with the dependent variable. Odds ratio with their 95% confidence intervals was computed to identify the presence and strength of association, and statistical significance was affirmed if p < 0.05.ResultThe current study evaluated 213 medical records of mothers with index neonates (71 cases and 142 controls). Urban residency [AOR = 0.48; 95% Cl; 0.239, 0.962], antenatal care follow up [AOR = 0.08; 95 Cl; 0.008, 0.694], premature rupture of membranes [AOR = 3.78; 95% Cl; 1.467, 9.749], pregnancy induced hypertension [AOR = 3.77; 95% Cl; 1.408, 10.147] and multiple pregnancies [AOR = 5.53; 95% Cl; 2.467, 12.412] were the factors associated with preterm birth. More than one-third (36.6%) preterm neonates died in the present study.ConclusionsThe present study found that urban residency, antenatal care follow up, premature rupture of membranes, pregnancy induced hypertension and multiple pregnancies were factors associated with preterm birth. The mortality among preterm neonates is high. Enhancing antenatal care follow up and early detection and treatment of disorders among pregnant women during antenatal care and undertaking every effort to improve outcomes of preterm birth and reduce neonatal mortality associated with prematurity is decisive.

Project description:BackgroundAdverse birth outcome is a common health problem consisting of several health effects involving pregnancy and the newborn infant. Infants with one or more adverse birth outcomes are at greater risk for mortality and a variety of health and developmental problems. Factors such as the age of the mother, antepartum hemorrhage, history of abortion, gestational age, anemia, and maternal undernutrition have predisposed the mother to adverse birth outcome. For appropriate prevention of the adverse birth outcomes, data pertaining to determinants of adverse birth outcomes are important. Therefore, this study was aimed to assess the determinants of adverse birth outcomes among women who give birth in public hospitals of western Ethiopia.MethodsAn institutional-based unmatched prospective case-control study was conducted from February 15 to April 15, 2020, in selected public hospitals of western Ethiopia. From mothers who gave birth in public hospitals of Wollega zones, 165 cases and 330 controls were selected. Mothers with adverse birth outcomes were cases and mothers without adverse birth were controls. Data was collected by structured interviewer-administered questionnaires. In addition to the interview, the data collectors abstracted clinical data by reviewing the mother and the babies' medical records. The collected data were entered into Epi info version 7 and exported to SPSS version 21 for analysis. Finally, multivariable logistic regression was used to identify determinants of adverse birth outcomes at P-value < 0.05.ResultsA total of 495 mothers (165 cases and 330 controls) were included in the study with a mean age of 28.48 + 5.908. Low ANC visit (AOR = 3.92: 95% CI; 1.86, 8.2), premature rupture of membrane (AOR = 2.83: 95% CI; 1.72,4.64), being Anemic (AOR = 2: 95% CI; 1.16,3.44), pregnancy induced-hypertension (AOR = 2.3:95% CI; 1.4,3.85), not getting dietary supplementation (AOR = 2.47:95% CI; 1.6,3.82), and physical abuse (AOR = 2.13: 95% CI; 1.05,4.32) were significantly associated with the development of the adverse birth outcome.ConclusionLow antenatal care visit, being anemic, premature rupture of membrane, pregnancy-induced hypertension, not getting dietary supplementation, and physical abuse were determinants of adverse birth outcomes. The clinicians should play a pivotal role to improve antenatal care follow up, counsel, and supplement recommended diets and minimize violence and abuse during pregnancy.