Determinants of Stillbirths in the Tamale Metropolitan Area

Abstract

Stillbirths are more common than the death of a baby after birth and remained a serious public health issue in the developing world. Although stillbirths are preventable, there has been a sharp increase in the rate of stillbirths in the Tamale Metropolitan area of Northern Ghana in the last couple of years. Majority of the causes and risk factors remained unknown. This study was conducted to assess the sociodemographic, obstetric and maternal medical related determinants of stillbirths. The findings will be used to guide policy change in stillbirth control and provide a basis for future studies of stillbirths in the Tamale Metropolitan area. Method A1:1 unmatched case control study was conducted in the Tamale Metropolitan area. Cases were defined as resident mothers of Tamale Metropolis who delivered singleton lifeless babies at or after 28 weeks of gestation from 1st January, 2012 to 31st December, 2013. Controls were those who had live births within the same period. We abstracted data from maternal health record booklets used in index pregnancies. Also, personal interviews with mothers on home visits was conducted. We estimated both crude and adjusted odds ratios, 95% confidence intervals and p values. Results A total of 368 mothers (184 cases and 184 controls) participated in the study. Maternal age of ≤ 24, prolonged labour (> 12 hours) and diastolic blood pressure of less than80mmHg in late pregnancy were significant determinants of stillbirths (aOR 3.0, 95% CI = 1.08 – 8.39; aOR 3.5, 95% CI = 1.94 – 6.61 and aOR 2.2, 95% CI = 1.04 – 4.54 respectively) Conclusion Low diastolic blood pressure in late pregnancy, young maternal age and prolonged labour were the key determinants of stillbirths in the Tamale Metropolis. Improvement of community moral practices and discouraging early marriage will help reduce the menace of stillbirths. Monitoring of blood pressure and labour should be prioritized Key: stillbirth, determinants, Tamale Metropolitan area