Association between obstetric and medical risk factors and stillbirths in a low‐income urban setting

• Published in: International journal of gynecology and obstetrics 2021-08, Vol.154 (2), p.331-336
• Main Authors: Gwako, George N., Obimbo, Moses M., Gichangi, Peter B., Kinuthia, John, Gachuno, Onesmus W., Were, Fredrick
• Format: Article
• Language: English
• Subjects: Adult; Case-Control Studies; Diabetes, Gestational - epidemiology; Female; Humans; Infant, Newborn; Kenya; low‐and‐middle‐income countries; medical complications; obstetric complications; Obstetric Labor Complications - epidemiology; Parity; Placenta; Poverty; Pre-Eclampsia - epidemiology; Pregnancy; Pregnancy Complications - epidemiology; Premature Birth; prenatal care; Prenatal Care - statistics & numerical data; Risk Factors; stillbirth; Stillbirth - epidemiology; Young Adult
• ISSN: 0020-7292; 1879-3479; 1879-3479
• DOI: 10.1002/ijgo.13528

Objective To evaluate the association between obstetric and medical risk factors and stillbirths in a Kenyan set‐up. Methods A case‐control study was conducted in four hospitals between August 2018 and April 2019. Two hundred and fourteen women with stillbirths and 428 with live births at more than >28 weeks of gestation were enrolled. Data collection was via interviews and ion from medical records. Outcome variables were stillbirth and live birth; exposure variables were sociodemographic characteristics, and medical and obstetric factors. The two‐sample t test and χ2 test were used to compare continuous and categorical variables respectively. The association between the exposure and outcome variable was done using logistic regression. A P value less than 0.05 was considered statistically significant. Results Stillbirth was associated with pre‐eclampsia without severe features (odds ratio [OR] 9.1, 95% confidence interval [CI] 2.6–32.5), pre‐eclampsia with severe features (OR 7.4, 95% CI 2.4–22.8); eclampsia (OR 9.2, 95% CI 2.6–32.5), placenta previa (OR 8.6 95% CI 2.8–25.9), placental abruption (OR 6.9 95% CI 2.2–21.3), preterm delivery(OR 9.5, 95% CI 5.7–16), and gestational diabetes mellitus, (OR 11.5, 95% CI 2.5–52.6). Stillbirth was not associated with multiparity, anemia, and HIV. Conclusion Proper antepartum care and surveillance to identify and manage medical and obstetric conditions with the potential to cause stillbirth are recommended. Synopsis Stillbirth is associated with hypertensive disorders, gestational diabetes, and prepartum hemorrhage. Proper prepartum care and surveillance to identify and manage these conditions is recommended.