Document Detail


Predictors of term stillbirths in an inner-city maternity hospital in Lagos, Nigeria.
MedLine Citation:
PMID:  19900141     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the rates, pattern and correlates of term/viable stillbirths (gestational age >or= 37 weeks and fetal weight >or= 2,500 g). DESIGN: Unmatched case-control, cross-sectional study. SETTING: Inner-city maternity hospital, Lagos, Nigeria. METHODS: About two-thirds of all documented stillbirths from 2005 to 2007 were analyzed to determine factors that correlated with viability by comparing term stillbirths first with pre-term stillbirths and then with term live births using multiple logistic regression. MAIN OUTCOME MEASURES: Prevalence rates and adjusted odds ratios at 95% confidence intervals (CIs). RESULTS: Of the total 7,216 deliveries over the three year period, there were 917 qualifying stillbirths out of which 404 (44.1%) were macerated and 13 (1.4%) were identified with congenital anomalies. Over half (57.0%) of the mothers with stillbirths had no antenatal care. Compared with pre-term stillbirths, term stillbirths were significantly associated with multiparity (odds ratio (OR) 0.69; 95% CI 0.48-0.99), antepartum hemorrhage (OR 0.54; 95% CI 0.35-0.83), premature rupture of membranes (OR 0.26; 95% CI 0.14-0.52), hypertensive conditions in pregnancy (OR 0.60; 95% CI 0.39-0.92), cesarean section (OR 1.71: 95% CI 1.13-2.60), cephalopelvic disproportion (OR 3.56; 95% CI 1.43-8.86), prolonged/obstructed labor (OR 1.94; 95% CI 1.22-3.07), and congenital abnormalities (OR 0.20; 95% CI 0.05-0.79). Young maternal age (OR 2.50; 95% CI 1.22-5.14), lack of antenatal care (OR 1.57; 95% CI 1.22-3.07), cord accidents (OR 29.63; 95% CI 14.23-61.71), and fetal distress (OR 5.30; 95% CI 3.35-8.38) emerged as additional risk factors when compared with term live births. CONCLUSIONS: While the uptake of antenatal care was generally poor, most factors associated with the unacceptably high proportion of viable stillbirths in this resource-poor setting were identical to risk factors for total stillbirths and can be effectively managed with improved maternal education and obstetric care.
Authors:
Bolajoko O Olusanya; Olumuyiwa A Solanke
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  88     ISSN:  1600-0412     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2009  
Date Detail:
Created Date:  2009-11-10     Completed Date:  2009-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  1243-51     Citation Subset:  IM    
Affiliation:
Maternal and Child Health Unit, Department of Community Health and Primary Care, College of Medicine, University of Lagos, Lagos, Nigeria. boolusanya@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Case-Control Studies
Cesarean Section
Cross-Sectional Studies
Female
Humans
Infant, Newborn
Male
Nigeria / epidemiology
Pregnancy
Prenatal Care
Prevalence
Risk Factors
Stillbirth / epidemiology*
Urban Population
Young Adult

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