Determinants of stillbirth among women who gave birth in public hospitals in Northwest Ethiopia, 2022

Abstract

INTRODUCTION: Stillbirth is still a major public health problem in middle- and low-income countries. However, there has been limited research conducted to identify determinants of stillbirth in Ethiopia. Therefore, this study aimed to identify the determinants of stillbirth among women who gave birth in public hospitals in the West Gojjam Zone, Northwest Ethiopia. METHODS: An unmatched case-control study was conducted among 418 mothers who gave birth from March 1-30, 2022. Consecutive and systematic sampling techniques were used to select the cases and controls, respectively. The collected data were entered into Epidata and exported into SPSS version 16 for analysis. Numerical descriptive statistics were expressed by using the mean with standard deviation (SD) and/or median with interquartile range (IQR), whereas categorical variables were expressed by proportions. Bivariable and multivariable binary logistic regression analyses were used to identify determinants of stillbirth. The model goodness of fit test was checked using the Hosmer-Lemeshow test. Variables having a P-value ≤ 0.25 in the bivariable analysis were entered into the multivariable analysis model. Adjusted odds ratio with 95% confidence intervals (CIs) was used to report the strength of association, and variables with a P-value < 0.05 were considered statistically significant. RESULTS: A total of 105 cases and 313 controls were included in this study. The odds of having stillbirth were higher among women who were illiterate (AOR: 1.6, 95% CI: 1.34, 7.55), had first ANC visit in the second trimester (AOR: 11.4, 95% CI: 2.99, 43.71), had an induced mode of delivery (AOR: 8.7, 95% CI: 2.10, 36.03), history of stillbirth (AOR: 1.5, 95% CI: 1.45, 4.90), bad obstetric history (AOR: 4.8, 95% CI: 1.44, 15.89), history of preterm (AOR: 7.6, 95% CI: 1.57, 37.21), not vaccinated for TT (AOR: 8.8, 95% CI: 2.23, 35.17), labor not followed by using partograph (AOR: 3.1, 95% CI: 1.10, 8.42), and history of abortion (AOR: 11, 95% CI: 2.91, 41.31). CONCLUSION: The determinants of stillbirth included women who were illiterate, started ANC visits in the second trimester, had an induced mode of delivery, history of stillbirth, bad obstetric history, history of preterm, history of abortion, not vaccinated for TT, and not followed by partograph. It is better to improve partograph utilization during intrapartum care and screen mothers who had a higher risk of adverse birth outcomes during their pregnancy to avert the problem.