Material and fetal risk factors for stillbirth in Otjozondjupa region, Namibia: A case control study
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Date
2018
Authors
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Journal ISSN
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Publisher
University of Namibia
Abstract
Background: Stillbirth is defined as a baby born with no signs of life (WHO). Globally, around 3.2 million stillbirths occur annually, of which, 98% are experienced in low and middle-income countries. By 2009, Namibia’s stillbirth rate was 15 per 1000 deliveries. Otjozondjupa Region toped the list of regions with high burden of stillbirth in Namibia
in 2016. Like many other countries, stillbirths are not prioritized and fewer resources are mobilized to curb them in relation to neonatal and maternal deaths. This study was aimed at determining risk factors associated with stillbirth in Otjozondjupa Region of Namibia
Methods: An unmatched case control study was conducted. A pilot tested questionnaire was used for data extraction. A sample of 285, 95 cases and 190 controls were chosen using simple random sampling method. Data was analyzed using Epi info 7. Whereby
bivariate and multivariate analyses were done to assess the risk factors of stillbirth. Odds ratio with 95% Confidence Intervals were calculated. Statistical significance was set at the p value of 0.05.
Results: In this study, no significant association was observed between socio-economic factors and stillbirth. However, stillbirth was significantly associated with some maternal medical and obstetric factors including, premature delivery (aOR 0.13 95% CI
0.05 – 0.33, p value 0.0001), gestational age (aOR 0.04, 95% CI 0.00 – 0.25, p value 0.0001), high-risk pregnancy (aOR 3.59, 95% CI 1.35 – 9.55, p value 0.01), duration of labour (aOR 4.04, 95% CI 1.56 – 10.43, p value 0.003) and ANC attendance (aOR 0.07, 95% CI 0.00 – 0.79, p value 0.03). On the other hand, only low birth weight of ≤ 2500 g was associated with stillbirth amongst fetal related factors (aOR 16.58, 95% CI 8.71 – 31.55, p value 0.0001). Some variables could not be assessed due to incomplete records. Conclusion: Stillbirth rate is high in Otjozondjupa Region hence a major concern. Stillbirth appeared to be mostly associated with maternal medical and obstetric factors. Importance of thorough Antenatal Care (ANC) examination and exhaustive obstetric care for all cases need to be emphasized. Emergency Obstetric and Newborn Care training is recommended for midwives is recommended.
Description
A thesis submitted in partial fulfillment of the requirements for the Degree of Master of Science in Applied Field Epidemiology
Keywords
Stillbirth, Marternal risk, Fetal risk