Trends and risk factors associated with stillbirths: A case study of the Navrongo War Memorial Hospital in Northern Ghana
Date
2020-02-21
Journal Title
Journal ISSN
Volume Title
Publisher
Plos One
Abstract
Background
Maternal and Child health remains at the core of global health priorities transcending the Millennium
Development Goals into the current era of Sustainable Development Goals. Most
low and middle-income countries including Ghana are yet to achieve the required levels of
reduction in child and maternal mortality. This paper analysed the trends and the associated
risk factors of stillbirths in a district hospital located in an impoverished and remote region of
Ghana.
Methods
Retrospective hospital maternal records on all deliveries conducted in the Navrongo War
Memorial hospital from 2003–2013 were retrieved and analysed. Descriptive and inferential
statistics were used to summarise trends in stillbirths while the generalized linear estimation
logistic regression is used to determine socio-demographic, maternal and neonatal factors
associated with stillbirths.
Results
A total of 16,670 deliveries were analysed over the study period. Stillbirth rate was 3.4% of
all births. There was an overall decline in stillbirth rate over the study period as stillbirths
declined from 4.2% in 2003 to 2.1% in 2013. Female neonates were less likely to be stillborn
(Adjusted Odds ratio = 0.62 and 95%CI [0.46, 0.84]; p = 0.002) compared to male neonates; neonates with low birth weight (4.02 [2.92, 5.53]) and extreme low birth weight (18.9 [10.9,
32.4]) were at a higher risk of still birth (p<0.001). Mothers who had undergone Female Genital
Mutilation had 47% (1.47 [1.04, 2.09]) increase odds of having a stillbirth compared to
non FGM mothers (p = 0.031). Mothers giving birth for the first time also had a 40% increase
odds of having a stillbirth compared to those who had more than one previous births (p =
0.037).
Conclusion
Despite the modest reduction in stillbirth rates over the study period, it is evident from the
results that stillbirth rate is still relatively high. Primiparous women and preterm deliveries
leading to low birth weight are identified factors that result in increased stillbirths. Efforts
aimed at impacting on stillbirths should include the elimination of outmoded cultural practices
such as FGM.
Description
Research Article
Keywords
Child health, Sustainable Development Goals, middle-income countries, Ghana
Citation
Nonterah EA, Agorinya IA, Kanmiki EW, Kagura J, Tamimu M, Ayamba EY, et al. (2020) Trends and risk factors associated with stillbirths: A case study of the Navrongo War Memorial Hospital in Northern Ghana. PLoS ONE 15(2): e0229013. https://doi.org/10.1371/journal. pone.0229013