மருத்துவ ஆராய்ச்சி இதழ்

The prevalence of stillbirth and it's associated risk factors at Kitwe Teaching hospital on the copperbelt province of Zambia

Abstract

Chikwalila Chipo*

Introduction: Stillbirth is a profound experience affecting millions of families worldwide every year. It is the most frequently reported adverse pregnancy outcome worldwide, which imposes significant psychological and economic consequences to mothers and affected families. The World Health Organization reports that there are nearly 2 million stillbirths every year. A lot of resources are dedicated to this area of research. Researchers worldwide are working hard to untangle the mystery surrounding the high prevalence of stillbirths. Majority of the causes and risk factors remain unknown, although some of them are preventable, the rate of stillbirths is very alarming. There is limited evidence on the pooled prevalence and associated factors of stillbirth in Zambia hence the need for this study.

Objective: To determine the prevalence of stillbirth and its associated risk factors at Kitwe teaching hospital in 2021.

Study design: Retrospective study.

Study area: Kitwe teaching hospital.

Method: This was a cross sectional retrospective study that included the use of a data extraction form to obtain secondary data from birth registry and maternal hospital records. The study took duration of 12 weeks. Data was entered and analyzed using the Statistical Package for Social Science (SPSS). Records of women of reproductive ages between 15 years and 50 years old who had stillbirths from January 2021 to December 2021 and delivered at KTH were randomly selected.

Results: Out of 384 total births, 17 stillbirths (4.4%) were observed. The SBR was calculated to be 44.16/1000 births. Out of the total number of stillbirths, 14 (82%) were macerated and 3 (18%) were fresh. Stillbirths were more common unregiste red women compared to registered women, that is 11 (65% and 6 (35%) respectively. A majority of the stillbirths, that is 9 (53% were found in women from the rural population. caesarean sections were 4 (24%) and vaginal deliveries 13 (76%) among stillbirths in this study. The majority of stillbirths 7 (41%) were seen in women above the age of 35. The prevalence of low birth weight (<2500 g) including 2500-4000 and >4000 was 8 (47%), 5 (29%) and 4 (24%) respectively. The proportion of preterm stillbirths was 7 (41%) and it was highest among stillbirths in the study population. The proportion of preterm delivery, hypertensive disorders of pregnancy, abruption and congenital malformations with stillbirth was estimated to be 7 (41%), 5 (29%), 4 (24%) and 4 (24%) and they were statistically significant (P<0.05). Though FGR, fetal distress and DM in pregnancy are potential risk factors for stillbirth, they were not significantly associated with stillbirth in this study.

Conclusion: Stillbirth remains a major public health problem in the country. The prevalence of stillbirth at KTH was found to be high compared to national and regional figures. These findings highlight the weak healthcare system of the country. There’s need to regularize uniform protocols for intranatal care in both urban and rural settings for a better neonatal outcome.