Stillbirths at Kitwe Teaching Hospital, Zambia (2020-2023): A Retrospective Descriptive Study of Prevalence, Trends, and Maternal-Fetal Characteristics

Abstract

Introduction: Stillbirth is a major public health problem, especially in low- and middle-income countries where problems with health systems contribute to high perinatal mortality . Understanding trends and determinants of stillbirths is essential for designing targeted interventions. Kitwe Teaching Hospital (KTH), a major referral hospital in Northern Zambia, experiences a significant burden of stillbirths. However, comprehensive local data on their patterns and risk factors are limited. We conducted a study to describe the prevalence, trends, and characteristics of stillbirths at Kitwe Teaching Hospital from 2020 to 2023. Methodology: A retrospective descriptive study was conducted using a total enumeration of medical records of stillbirths at Kitwe Teaching Hospital between 2020 and 2023. A complete case analysis was used for the records that were finally included in the study. Maternal and fetal characteristics were extracted by using a standardized form and analyzed by using SPSS version 23. Results: Of 7723 births, 278 stillbirths were reported, resulting in an overall stillbirth rate of 36 per 1000 births. The rate declined from 43 per 1,000 in 2020 to 30 per 1,000 in 2023. A Chi-square test for trend (Cochran–Armitage) showed a borderline statistically significant downward trend in stillbirth rates over the study period (χ 2 = 3.83, p = 0.05). Most mothers were aged 25-29 years (31.3%), were multigravida (56.5%), and were HIV positive (20.1%). Vaginal delivery was predominant (74.8%), and common pregnancy complications were antepartum hemorrhage (9.7%) and severe preeclampsia (5.4%). Among stillborn babies, 55.4% were female, most had birth weights between 1,500-2,499 grams (37.1%) and 43.9% occurred at late preterm gestation (36 weeks). Conclusion: Stillbirth rates at Kitwe Teaching Hospital show a gradual decline, yet the burden remains significant. These findings can guide targeted interventions to further reduce stillbirths at the Kitwe Teaching Hospital.