Determinants of stillbirth among mothers in Asella Referral and Teaching Hospital, Oromia Regional State, Ethiopia: An unmatched case-control study

Determinants of Stillbirth in Referral and Teaching Hospital

Abstract

Background: Ethiopia experiencing one of the highest rates in East Africa. Despite several measures taken to reduce this burden, the stillbirth rate in Ethiopia remains considerably high. Efforts to lower these rates may be hampered by an incomplete understanding of the underlying risk factors. Therefore, this study aims to identify the determinants of stillbirth among mothers who gave birth at Asella Referral and Teaching Hospital.

Methods: An unmatched case-control study was conducted from February 11 to August 31, 2022, at Asella Referral and Teaching Hospital. A total of 351 postpartum women were enrolled with a case-to-control ratio of 1:2 (117 cases and 234 controls). Cases were defined as postpartum mothers who gave birth to a stillborn infant at 28 weeks or more of gestation, or with a birth weight of 1 kg or more, or a body length of 35 cm or more. However, controls included postpartum mothers who gave birth to a live-born infant meeting the same characteristics of cases. Data were entered into EpiData and analyzed by SPSS. Descriptive statistics as well as binary and multivariable logistic regression analyses were used to assess the associations between independent and dependent variables. Statistical significance was determined at a P-value of less than 0.05.

Results: A total of 351 women participated in this study, yielding a 100% response rate. Having a birth interval of less than 2 years (AOR = 4.1, 95% CI: 1.2–13.4), antepartum hemorrhage (AOR = 13.1, 95% CI: 2.4–17.5), and having preeclampsia (AOR = 7.0, 95% CI: 1.4–35.4) were significantly associated with stillbirth. In addition, rural residence (AOR = 13.0, 95% CI: 3.4–29.9), being referred from another health facility (AOR = 6.1, 95% CI: 2.3–16.2), antenatal care (ANC) contact at 28 weeks or later (AOR = 12.5, 95% CI: 3.2–21.4), preterm birth (AOR = 14.6, 95% CI: 2.4–27.3], and having a birth weight under 2500 grams (AOR = 10.6, 95% CI: 3.2–24.9) were significantly associated with stillbirth.

Conclusion: In the present study, several factors were significantly associated with stillbirth. Targeted interventions are vital for mothers who are rural residents, have a birth interval of less than two years, or are referred from other health facilities to reduce stillbirth burden. Furthermore, addressing clinical factors such as late antenatal care (ANC) follow-up, preeclampsia, antepartum hemorrhage, preterm delivery, and low birth weight are is crucial.