BACKGROUND: Recent studies have shown that the most important risk factors for perinatal mortality in developing countries are not detectable during antenatal care but can be observed only shortly before or during labour. Although 60% of perinatal deaths in these countries are stillbirths, few epidemiological studies focus on them. We tested the hypothesis that the risk factors for late stillbirth in West Africa are detectable principally shortly before or during labour. METHODS: Data came from a prospective population-based study (the MOMA survey) that collected information about 20 326 pregnant women in seven areas, primarily urban, in West Africa. RESULTS: There were 19 870 singleton births. The stillbirth rate was 25.9 per 1000 total births (95% CI: 23.7-28.1). In the crude analysis, after adjustment and consideration of prevalence, the principal risk factors for late stillbirth were: late antenatal or intrapartum vaginal bleeding, intrapartum hypertension, dystocia, and infection. Other risk factors were: maternal height (<150 cm), maternal age (>35 years), previous stillbirths, hypertension at the 8-month antenatal visit and number of antenatal visits (<2). CONCLUSIONS: The principal risk factors for late stillbirth observed in our study could be detected only in the late antenatal and intrapartum period. These results highlight the potential benefits of partograph use. They need to be confirmed by studies incorporating continuous intrapartum fetal monitoring.
BACKGROUND: Recent studies have shown that the most important risk factors for perinatal mortality in developing countries are not detectable during antenatal care but can be observed only shortly before or during labour. Although 60% of perinatal deaths in these countries are stillbirths, few epidemiological studies focus on them. We tested the hypothesis that the risk factors for late stillbirth in West Africa are detectable principally shortly before or during labour. METHODS: Data came from a prospective population-based study (the MOMA survey) that collected information about 20 326 pregnant women in seven areas, primarily urban, in West Africa. RESULTS: There were 19 870 singleton births. The stillbirth rate was 25.9 per 1000 total births (95% CI: 23.7-28.1). In the crude analysis, after adjustment and consideration of prevalence, the principal risk factors for late stillbirth were: late antenatal or intrapartum vaginal bleeding, intrapartum hypertension, dystocia, and infection. Other risk factors were: maternal height (<150 cm), maternal age (>35 years), previous stillbirths, hypertension at the 8-month antenatal visit and number of antenatal visits (<2). CONCLUSIONS: The principal risk factors for late stillbirth observed in our study could be detected only in the late antenatal and intrapartum period. These results highlight the potential benefits of partograph use. They need to be confirmed by studies incorporating continuous intrapartum fetal monitoring.
Authors: Margaret E Kruk; Todd P Lewis; Catherine Arsenault; Zulfiqar A Bhutta; Grace Irimu; Joshua Jeong; Zohra S Lassi; Susan M Sawyer; Tyler Vaivada; Peter Waiswa; Aisha K Yousafzai Journal: Lancet Date: 2022-04-27 Impact factor: 202.731
Authors: Anne C C Lee; Joy E Lawn; Simon Cousens; Vishwajeet Kumar; David Osrin; Zulfiqar A Bhutta; Steven N Wall; Allyala K Nandakumar; Uzma Syed; Gary L Darmstadt Journal: Int J Gynaecol Obstet Date: 2009-10 Impact factor: 3.561
Authors: George N Gwako; Moses M Obimbo; Peter B Gichangi; John Kinuthia; Onesmus W Gachuno; Fredrick Were Journal: Int J Gynaecol Obstet Date: 2020-12-29 Impact factor: 4.447
Authors: Naoko Kozuki; Anne C C Lee; Mariangela F Silveira; Ayesha Sania; Joshua P Vogel; Linda Adair; Fernando Barros; Laura E Caulfield; Parul Christian; Wafaie Fawzi; Jean Humphrey; Lieven Huybregts; Aroonsri Mongkolchati; Robert Ntozini; David Osrin; Dominique Roberfroid; James Tielsch; Anjana Vaidya; Robert E Black; Joanne Katz Journal: BMC Public Health Date: 2013-09-17 Impact factor: 3.295