Abstract
ObjectivesStillbirth is a major global health issue, which disproportionately affects families living in low-income and middle-income countries. The Solomon Islands is a Pacific nation with poor perinatal outcomes, however research investigating stillbirth is lacking. Thus, we aimed to investigate the incidence and cause of stillbirth occurring at the National Referral Hospital, Solomon Islands.DesignWe conducted a retrospective cohort study from January 2017 to December 2018.SettingAt the only tertiary referral hospital in the Solomon Islands, on the main island of Guadalcanal.ParticipantsAll births occurring in the hospital during the study period.Outcome measuresNumber of, causes and risk factors for stillbirths (fetal deaths before birth at ≥20 estimated gestational weeks, or ≥500 g in birth weight).ResultsOver 2 years 341 stillbirths and 11 056 total births were recorded, giving an institutional incidence of 31 stillbirths per 1000 births. Of the cases with a recorded cause of death, 72% were deemed preventable. Most stillbirths occurred antenatally and 62% at preterm gestations (<37 weeks). 59% had a birth weight below 2500 g and preventable maternal conditions were present in 42% of the cases. 46% of the cases were caused by an acute intrapartum event, and among these 92% did not receive intrapartum monitoring.ConclusionsStillbirth affects 31 in every 1000 births at the National Referral Hospital in the Solomon Islands and many cases are preventable. Our findings highlight the urgent need for increased focus on perinatal deaths in the Solomon Islands with universal classification and targeted training, improved quality of obstetrical care and community awareness.
Funder
The National Health and Medical Research Council of Australia
Reference37 articles.
1. National, regional, and worldwide estimates of stillbirth rates in 2009 with trends since 1995: a systematic analysis
2. National, regional, and worldwide estimates of stillbirth rates in 2015, with trends from 2000: a systematic analysis;Blencowe;Lancet Glob Health,2016
3. Stillbirths: rates, risk factors, and acceleration towards 2030
4. Stillbirth in low- and middle-income countries: addressing the 'silent epidemic';Aminu;Int Health,2019
5. Stillbirth rates in low-middle income countries 2010 - 2013: a population-based, multi-country study from the Global Network;McClure;Reprod Health,2015