Stillbirth Rate and Some Predictors in a Tertiary Hospital in the Niger Delta Area of Nigeria

Abstract

Aim: To determine stillbirth rate and identifiable predictors from a sample of deliveries in our setting. Study Design: A retrospective analysis of a cross-sectional dataset. Place and Duration of Study: Study was conducted at the Federal Medical Centre Yenagoa (FMCY), Bayelsa State, Nigeria using data collected between July 2020 and April 2021. Methodology: A cross-sectional dataset of 584 births at the FMCY was analysed. Variables included in the data were women’s age, level of education, booking status, parity, number of fetuses, onset of labour, mode of delivery, urgency of CS, fetal maturity, fetal lie, fetal presentation, fetal sex, birth weight categories and stillbirth or live birth. Stillbirth was defined as a baby born at ≥ 28 completed weeks of gestation or weighing ≥ 1000 grams with no signs of life. Data was analysed using IBM SPSS Statistics version 25. Results: Of the 584 births during the study period, 53 were stillbirths giving a prevalence of 9.1% and stillbirth rate of 90.8/1000 total births. Unbooked status conferred >4 times higher odd of stillbirth (AOR = 4.36; 95% CI = 2.13 – 8.93; pValue < 0.001) relative to a booked status. Relative to delivery by pre-labour caesarean section, odd of stillbirth was about 8.3 times and 15.9 times higher among women in spontaneous labour (AOR = 8.30; 95% CI = 2.27 – 30.36; pValue = 0.001) and women with induced labour (AOR = 15.91; 95% CI = 2.03 – 125.06; pValue = 0.009) respectively. Post-term gestation had 16 times significantly higher odd of stillbirth (AOR = 15.74; 95% CI = 1.35 – 183.91; pValue = 0.028) relative to term gestation. Conclusion: This study establishes an unbooked status and post-term gestation as predictors of stillbirth in our setting. It also underscores the need to include the status of the fetus at presentation in labour (alive or IUFD) in data collection and analysis when studying the role of labour in incidence of stillbirth.