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Factors associated with fresh stillbirths: A hospital‐based, matched, case–control study in Burkina Faso
Author(s) -
Millogo Tieba,
Ouédraogo Gautier H.,
Baguiya Adama,
Meda Ivlabèhiré Bertrand,
Kouanda Seni,
Sondo Blaise
Publication year - 2016
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2016.08.012
Subject(s) - medicine , conditional logistic regression , odds ratio , referral , logistic regression , case control study , health facility , obstetrics , psychological intervention , odds , pediatrics , pregnancy , gestational age , demography , environmental health , population , family medicine , health services , nursing , sociology , biology , genetics
Objective To determine the risk factors for fresh stillbirths in hospitals in Burkina Faso. Methods A hospital‐based, matched (1:1), case–control study was conducted from July to August 2014 in 50 hospitals across the country. All cases of stillbirth that occurred during this period in the participating facilities were included, and an appropriate control was selected for each case from the same health facility. Cases and controls were matched for gestational age. Conditional logistic regression with robust standard errors was used to compute both unadjusted and adjusted conditional odds ratios. Results Cases were 67% less likely to have been delivered by a midwife compared with a nonmidwife attendant (ACOR = 0.33; 95% CI, 0.12–0.84; P = 0.02). Use of a partograph to monitor labor lowered the odds of fresh stillbirth by 82% (ACOR = 0.18; 95% CI, 0.05–0.61; P = 0.006). Mothers who had been transferred from another health facility were five times more likely to experience a fresh stillbirth (ACOR = 5.36; 95% CI, 2.02–14.23; P < 0.001). Conclusion Quality and timing of intrapartum obstetric care is key to preventing fresh stillbirths. Easy to implement and available interventions, such as use of a partograph for all laboring women and improving the referral system, have the potential to save the lives of many fetuses.