Maternal and fetal risk factors for stillbirth in Northern Tanzania: A registry-based retrospective cohort study.

Autor: Chuwa FS; Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical College, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Mwanamsangu AH; Kilimanjaro Christian Medical University College, Moshi, Tanzania.; Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania., Brown BG; Department of Global Health,Weill Cornell Medical College, New York, NY, United States of America., Msuya SE; Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical College, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania.; Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania., Senkoro EE; Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical College, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Mnali OP; Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical College, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Mazuguni F; Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical College, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania., Mahande MJ; Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical College, Moshi, Tanzania.; Kilimanjaro Christian Medical University College, Moshi, Tanzania.; Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2017 Aug 15; Vol. 12 (8), pp. e0182250. Date of Electronic Publication: 2017 Aug 15 (Print Publication: 2017).
DOI: 10.1371/journal.pone.0182250
Abstrakt: Background: Stillbirth is a major cause of perinatal mortality and occurs disproportionately in developing countries including Tanzania. However, there is scant information regarding the predictors of this condition in Tanzania. This study aimed to determine maternal and fetal risk factors for stilbirth in northen Tanzania.
Methodology: A retrospective cohort study was performed using maternally-linked data from the Kilimanjaro Christian Medical Centre birth registry. A total of 47681 women who had singleton delivery at KCMC between 2000 and 2014 were analyzed. Women with multiple gestations were excluded. Descriptive statistics were summarized using proportions and frequency. Chi-square test was used to determine risk factors for stillbirth in bivariate analysis. A multivariable regression model was used to estimate adjusted odds ratios (AOR) with 95% confidence intervals for maternal and fetal factors associated with stillbirth. A p-value of less than 0.05 was considered statistically significant.
Results: The frequency of stillbirth was 3.5%. Pre-eclampsia (AOR 3.99; 95% CI: 3.31-4.81) and placental abruption (AOR 22.62; 95% CI: 15.41-33.19) were the strongest maternal risk factors associated with still birth. While non-cephalic presentation (AOR 6.05; 95% CI: 4.77-7.66) and low birth weight (AOR 9.66; 95%CI: 8.66-10.77) were the fetal factors with the greatest impact on stillbirth.
Conclusion: The rate of stillbirth in our study was consistent with past studies of developing countries. Numerous maternal and fetal factors risk factors were identified. Early identification of at risk pregnancies and appropriate intervention may help to reduce the occurrence of stillbirth.
Databáze: MEDLINE
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