Abstract
Background
Predominantly, stillbirths occur in Low- and middle-income countries, with 75% of stillbirths occurring in sub-Saharan Africa and southern Asia. In Ghana, the stillbirth rate is 22/1000 births. Sadly, there is still limited understanding of the determinants of stillbirths in many parts of Africa, including the Savannah region of Ghana. This study examined the characteristics and predictors of stillbirths at the West Gonja Catholic Hospital from 1st January 2019 to 31 December 2020.
Methods
A retrospective, unmatched case-control study that compared data of mothers with stillbirths to mothers with live births at the West Gonja Catholic Hospital, was conducted. The total sample was 385 mothers (55 stillbirths and 330 live births) who delivered at the West Gonja Catholic Hospital from 1st January 2019 to 31st December 2020. The data were extracted from delivery registers in the labour ward using a Microsoft Excel data extraction form. We used logistic regression to estimate crude and adjusted odds ratios at a 95% confidence level.
Results
Completing Junior High School reduces the odds of a stillbirth (aOR 0.16 95% CI = 0.03–0.77, p < 0.022). The odds of having a stillbirth were higher among mothers who lived in rural areas (aOR 2.92, 95% CI = 1.01–7.86, P < 0.034), mothers who made < 4 antenatal visits (aOR = 6.11, 95%CI = 2.35–15.88, p < 0.01 ), mothers with hypertensive disease in pregnancy (aOR 10.56 95%CI = 2.31–48.26, p < 0.002), mothers who took < 3 doses of IPTp during pregnancy (aOR 11.26 95%CI = 4.38–28.97, p < 0.01 ), mothers who delivered preterm babies (aOR 13.14 95%CI = 3.16–54.58, p < 0.01), mothers who delivered postdate babies (aOR 9.77, 95%CI = 2.62–36.37), p < 0.01), and mothers with breech presentation of the foetus at birth (aOR 55.82, 95%CI = 8.53-365.44, p < 0.01).
Conclusion
A combination of socio-demographic, maternal and foetal factors determined stillbirth at the West Gonja Catholic Hospital between 1st January 2019 and 31st December 2020. Continuous community sensitisation on the effect of key risk factors, early classification of pregnancies into risk groupings and institution of special ANC for high-risk groups are recommended to improve on birth outcomes at the hospital. Other innovative strategies such as domiciliary antenatal care services are recommended to improve the timing and number of ANC attendance. Continuous professional development of midwives and community health nurses in the identification, management and timeous referral of high-risk pregnancies and labour are also recommended to help reduce this undesirable outcome of pregnancy.