TY - JOUR
T1 - Predisposing factors associated with stillbirth in Tanzania
AU - Kidanto, Hussein
AU - Msemo, Georgina
AU - Mmbando, Donan
AU - Rusibamayila, Neema
AU - Ersdal, Hege
AU - Perlman, Jeffrey
N1 - Publisher Copyright:
© 2015 Published by Elsevier Ireland Ltd. on behalf of International Federation of Gynecology and Obstetrics.
PY - 2015/7/1
Y1 - 2015/7/1
N2 - Objective To determine whether specific medical conditions and/or fetal compromise during labor are associated with fresh stillbirth (FSB), and whether absent fetal heart rate (FHR) before delivery can increase risk of FSB. Methods An observational cohort study was conducted at three university referral hospitals in Tanzania between January and September 2013. Maternal, labor, and neonatal characteristics were recorded for all deliveries. FSB was defined as an Apgar score of 0 at 1 and 5 minutes, with intact skin and suspected death during labor or delivery. Results Among 15 305 deliveries, there were 499 stillbirths (243 FSBs and 256 macerated stillbirths). Stillbirth was significantly more likely than a live birth after maternal transfer (odds ratio [OR] 3.27; 95% confidence interval [CI] 2.73-3.92; P < 0.001) and when FHR was absent (OR 996.29; 95% CI 632.19-1570.09; P < 0.001). Risk of stillbirth increased with uterine rupture (OR 138.62; 95% CI 60.73-316.44), placental abruption (OR 40.96; 95% CI 28.97-57.91), cord prolapse (OR 13.49; 95% CI 6.97-26.11), and prematurity (OR 6.87; 95% CI 4.71-10.03; P < 0.001 for all). Conclusion In low-resource settings, FSB may be prevented by using a combined strategy of clinical risk identification, early detection of abnormal FHR, and expedited delivery.
AB - Objective To determine whether specific medical conditions and/or fetal compromise during labor are associated with fresh stillbirth (FSB), and whether absent fetal heart rate (FHR) before delivery can increase risk of FSB. Methods An observational cohort study was conducted at three university referral hospitals in Tanzania between January and September 2013. Maternal, labor, and neonatal characteristics were recorded for all deliveries. FSB was defined as an Apgar score of 0 at 1 and 5 minutes, with intact skin and suspected death during labor or delivery. Results Among 15 305 deliveries, there were 499 stillbirths (243 FSBs and 256 macerated stillbirths). Stillbirth was significantly more likely than a live birth after maternal transfer (odds ratio [OR] 3.27; 95% confidence interval [CI] 2.73-3.92; P < 0.001) and when FHR was absent (OR 996.29; 95% CI 632.19-1570.09; P < 0.001). Risk of stillbirth increased with uterine rupture (OR 138.62; 95% CI 60.73-316.44), placental abruption (OR 40.96; 95% CI 28.97-57.91), cord prolapse (OR 13.49; 95% CI 6.97-26.11), and prematurity (OR 6.87; 95% CI 4.71-10.03; P < 0.001 for all). Conclusion In low-resource settings, FSB may be prevented by using a combined strategy of clinical risk identification, early detection of abnormal FHR, and expedited delivery.
KW - Fresh stillbirths
KW - Low-resource area
KW - Stillbirths
KW - Tanzania
UR - http://www.scopus.com/inward/record.url?scp=84937512716&partnerID=8YFLogxK
U2 - 10.1016/j.ijgo.2015.01.012
DO - 10.1016/j.ijgo.2015.01.012
M3 - Article
C2 - 25842995
AN - SCOPUS:84937512716
SN - 0020-7292
VL - 130
SP - 70
EP - 73
JO - International Journal of Gynecology and Obstetrics
JF - International Journal of Gynecology and Obstetrics
IS - 1
ER -