Magnitude and determinants of stillbirth in mizan-tepi teaching hospital, southwest, Ethiopia

Abstract

Introduction: Stillbirth rate is an important indicator of quality of care in pregnancy and childbirth, as well as a sensitive marker of health systems’ strength. Despite, continues efforts for several decades globally, still nearly 2.6 million stillbirths occur each year. About 98% of this occurs in low and middleincome countries and three quarters in south Asia and sub-Saharan Africa. Despite its importance, up to date data on the magnitude and determinants of stillbirth are limited in Ethiopia in general and in MizanTepi teaching hospital in particular. Hence, this study aimed to fill this gap. Objective: To determine the magnitude and identify determinants of stillbirth in Mizan-Tepi teaching hospital, South west Ethiopia. Methods: Facility-based unmatched case-control study was conducted using delivery data from January 01, 2017-December31, 2019.Stillbirths were taken as cases and live births were taken as controls. A sample of 270 (90cases and180 controls) were included in the study. The collected data were entered into EPI Data Version 3.1and exported to SPSS Version 21 for analysis. Descriptive statics was used to check distribution of stillbirth and to describe the study population in relation to each variable. Candidate variables with p value< 0.25 in bivariate logistic regression were entered into multivariate logistic regression model to identify determinants of stillbirth. After the multivariate logistic regression analysis variables having p-values <0.05 was taken as statistically significant. Odds ratio with 95% confidence interval was used to measure the existence and strength of the association. Result: A total of 261 maternal cards were included in the analysis. The overall stillbirth rate was 44 per 1000 deliveries. The odds of not having ANC follow-up were significantly higher among cases as compared to controls (AOR=3.1; 95%CI: 1.51, 6.40). Similarly, the odds of having at least one complication during pregnancy(AOR=2.8; 95%CI: 1.38, 5.80), not using partograph for labor monitoring(AOR=4.0; 95%CI:1.88,8.47), being anemic mother (AOR=2.6; 95%CI:1.28,5.56), coming after referral from other facilities (AOR=2.3; 95%CI:1.06,5.00) and having past history of stillbirth(AOR=4.4; 95%CI:1.36,14.4) were significantly higher among cases as compared to controls. Conclusion and recommendation: The magnitude of stillbirth in this study is found to be high. History of stillbirth, referral status, use of partograph, ANC follow-up, obstetric complication and maternal hemoglobin were found to be determinants of stillbirth. Appropriate ANC follow up, routine iron supplementation during pregnancy are recommended. In addition, proper use of Partograph for labor monitoring and timely referrals can reduce the high rate of stillbirth